Introduction
The human body comprises multiple tissues and organs, which are designated to perform specific functions. For example, the liver plays a vital role in filtering blood and eliminating toxins from the body. Most commonly, alcohol is the main cause of liver damage. Besides alcohol, certain genetic and medical conditions may affect the liver. The treatment for each condition may depend on the overall health of the individual, the extent of the damaged liver tissues, and the complications.
For example, a hepatic cyst is a liver condition in which fluid-filled sacs are developed within the liver. The cyst may remain asymptomatic and may be found accidentally in medical examination. At times the cyst may cause symptoms like nausea, pain, and vomiting. In such cases, surgical intervention may be required to carefully excise the cyst. This article will give a detailed explanation of the various surgical approaches to treat hepatic cysts.
What Is a Hepatic Cyst?
Hepatic cysts are sacs of fluid that are commonly seen on the liver. Most hepatic cysts are benign and do not cause any symptoms. Very rarely, a few cysts may grow large enough to cause a few symptoms. At times, the cysts may also be caused due to genetic disorders. The benign hepatic cysts are otherwise known as simple cysts and is estimated that over five to ten percent of people worldwide may suffer from cysts.
What Are the Causes of Hepatic Cysts?
The various factors contributing to hepatic cysts are mentioned below:
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Simple Cyst Formation: They are the most common type and may not be associated with any underlying disease. They are often linked to abnormalities in the bile duct.
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Polycystic Liver Disease: It is a genetic disorder in which multiple cysts are found in the liver. It is often associated with kidney disease.
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Acquired Cyst: It develops as a result of an infection or injury that affects the liver.
What Are the Symptoms of Hepatic Cysts?
Hepatic cysts may not cause symptoms, as they are incidental findings during imaging tests. The symptoms are typically mild and vary depending on the size and location of the cyst. A few common symptoms of hepatic cysts include:
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Pain and discomfort in the upper right abdomen area. It is usually dull and intermittent. It may be triggered by physical activity and changes in the body position.
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Some individuals may experience a sense of fullness or bloating.
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In the case of larger cysts, nausea is a common symptom.
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If the cyst exerts pressure on the diaphragm, the individual may have difficulty in breathing.
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In case of any infection in the cyst, an individual may experience fevers, chills, and abdominal pain.
What Are the Surgical Treatment Options for Hepatic Cysts?
In hepatic cysts, surgical treatment is only considered when the cyst growth is very rapid and causes significant symptoms that may affect the overall health of the patient. There are different types of surgical approaches to the cyst, which depend on the size, location, and characteristic features of the cyst. Some of the common surgical approaches are mentioned below:
Cystectomy:
A surgical procedure that is used to remove the cyst from various parts of the liver. It is only considered when the cysts are too large, numerous, and complex. It can be treated effectively with lesser invasive procedures like cyst fenestration.
Before undergoing the procedure, the patient will be thoroughly examined to determine the size and location of the cyst. Then the patient will be placed under general anesthesia so that there is no pain during the procedure. The surgery will be performed using minimally invasive techniques.
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In open cystectomy, the surgeon makes a larger incision on the abdominal wall to access the liver and carefully identifies the cyst by removing it slowly from the surrounding tissues. This is used for larger cysts.
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In laparoscopic surgery, a minimally invasive technique is used to make several smaller incisions. Through these incisions, a flexible tube is inserted. A camera is attached to this tube, which helps the surgeon to get a clear picture of the affected site. The advantage of this technique is lesser postoperative pain and shorter recovery time.
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After gaining access, the surgeon completely removes the cyst from the healthy liver tissue.
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Then incisions are closed with the help of a suture or staples. Post-surgery, the patient is monitored for any complications. In a few cases, medications are prescribed to prevent any infections.
Cyst Fenestration:
This procedure is also known as cyst deroofing and is specifically used for hepatic cysts. It is a minimally invasive procedure that creates an opening in the wall to allow fluid to drain into the abdominal cavity.
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After undergoing a comprehensive evaluation, the patient is given general anesthesia, which allows them to avoid pain during surgery.
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The surgeon then typically performs a minimally invasive technique by making a small incision on the cyst wall to allow the fluid to drain completely.
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After draining, the surgeon confirms that there are no remains of the fluid within the cavity.
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Cyst fenestration is a safe and effective treatment for certain hepatic cysts that constantly cause symptoms.
Liver Resection:
In some cases, the cyst may be located in close proximity to the blood vessel or may lie deep within the liver tissue. In such cases, a liver resection may be necessary. It involves removing a portion of the liver that contains the cyst, and it is very invasive. It is usually performed in cysts where other modes of treatment are impossible.
Liver Transplantation:
Although it is extremely rare, the hepatic cyst affects the entire organ, and transplantation may be required to restore normal functions in the liver.
Conclusion
Hepatic cysts are usually benign and may not require treatment. If the patient exhibits symptoms, then medical or surgical intervention may be required. The different modalities include cystectomy, cyst fenestration, liver resection, and liver transplantation. The type of surgery will be declared after thoroughly examining the patient and understanding the size and extent of the cyst. Post-surgery follow-ups may be required to check for recurrence and complete healing.
