A simple cyst in the liver is a benign tumor originating from the small bile ducts, which is a cavity with fluid inside, and can form anywhere in the liver.
Cysts in the liver can be benign (simple cyst, cystadenoma), parasitic (echinococcal, alveococcal) and malignant (cystadenocarcinoma).
Advantages of treatment of liver cysts in EMC
The EMC is equipped with high-tech modern equipment for the diagnosis and minimally traumatic operations for liver cysts.
The operation is performed by hepatopancreatobiliary surgeons with extensive experience in performing operations of any complexity for liver cysts (both malignant and benign).
A multidisciplinary team of doctors to create an individual treatment plan for each patient for Laparoscopic and puncture low-trauma operations with minimal rehabilitation time.
Laparoscopic and puncture low-trauma surgeries with minimal rehabilitation time.
Symptoms of liver cyst
In the presence of uncomplicated and small formations, the patient does not experience any symptoms. Cysts of large size (10-20 cm) are adjacent to the surface of the liver, stretching its capsule, therefore they can be accompanied by pain syndrome. They can also put pressure on the kidneys and stomach and cause discomfort in the upper abdomen and in the right lumbar region. Pain and various symptoms can occur with suppuration and hemorrhage into the cyst cavity, its rupture or breakthrough into the bile ducts, free abdominal cavity or bronchi.
Classification
Benign and malignant, primary and secondary cystic tumors are distinguished. Simple benign cysts are rarely complicated. There is also such a benign type as cystadenoma, which is regarded as a precancerous disease. Cystadenomas are divided into serous and mucinous (the former are less likely to undergo malignant transformation, unlike the latter).Often, false liver cysts can form after injury, when, after resorption of the hematoma, a cavity filled with serous or hemorrhagic contents remains.
Diagnosis of liver cysts
A cyst is a fluid formation that is easy to spot on ultrasound and understand where it is located (in the right lobe, left, center). Computed tomography (CT) and magnetic resonance imaging (MRI) are necessary if surgical or puncture treatment is planned or if there are doubts about the diagnosis. If a malignant transformation is suspected, positron emission tomography is performed.
Treatment of cysts in the liver
Depending on the type of cyst and its size, treatment methods are selected. This can be a medical treatment or one of the types of surgical (laparoscopic operations, puncture and drainage, open surgery). Drug treatment is often chosen for small parasitic cysts up to 1 cm deep in the liver. It is also used in addition to surgery for parasitic cysts.
Treatment of liver cysts
Depending on the type of cyst and its size, treatment methods are selected. This can be a medical treatment or one of the types of surgical (laparoscopic operations, puncture and drainage, open surgery). Drug treatment is often chosen for small parasitic cysts up to 1 cm deep in the liver. It is also used in addition to surgery for parasitic cysts.
Surgical treatment of a cyst in the liver
In most cases, with simple liver cysts, minimally invasive intervention is performed under ultrasound control. The operation can be divided into three stages:
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This is a puncture using a special needle that takes samples of cyst contents
- A tube is inserted into the cyst cavity, it is removed after 1-2 weeks
- At the end of the operation, the surgeon treats the cyst (its walls) with alcohol in order to reduce secretion. The same treatment method is used for false liver cysts. In this case, there is no need to only manage alcohol (ethanol)
In some cases, with pain syndrome associated with large cyst sizes, puncture and drainage treatment is possible.
If the cyst is larger than 10 cm, it is treated with laparoscopic surgery, which is also a minimally invasive method. Surgical intervention is performed under the supervision of a videolaparoscope. The surgeon excises the walls of the formation and treats the remaining walls (on the surface of the liver) with alcohol. The method is low-traumatic and does not require large incisions.
In the case of cystadenoma, the type of surgery (laparoscopic or open) depends on the location of the cyst. It is also important for surgeons to understand whether reconstruction of the bile duct is required (it is necessary in cases where cysts are located in the central part of the liver and are connected to these ducts). In this situation, an open operation is required.
With parasitic cysts, the treatment approaches are similar, however, antiparasitic treatment is necessary during surgery, as well as removal of all elements (daughter cysts, parasite) and suturing of possible fistulas in the bile ducts.
With alveococcosis, it is very often necessary to perform duct resection along with the affected part of the liver. Despite the fact that it is a parasitic benign disease, it resembles a malignant one in its growth pattern. The cyst grows into the vessels and into the bile ducts, so the operation is performed according to oncological principles.
In the absence of concomitant diseases, special preparation for the above operations for liver cysts is not required.
Possible complications
Any surgical treatment can cause complications. These may be complications of puncture and drainage treatment: for example, after treating cysts with alcohol, the patient may experience pain, but it passes quickly. After laparoscopic operations, intra-abdominal bleeding occurs (it is rare, in 0:5-1% of cases).
After major liver surgeries, fluid accumulations in the resection area, bleeding, bile leakage, hematomas, wound suppuration, and fluid accumulation in the pleural cavity are possible. If the patient had to donate his liver, then after the removal of the organ, he may experience pneumonia, embolism, deep vein thrombosis, and thromboembolism.
But all of these are common complications that may be present after any surgery. It is extremely important that the treatment is carried out by a surgeon with many years of experience in performing such interventions, and a multidisciplinary team of doctors participates in the process of preparing for surgery and subsequent rehabilitation.
Forecast
The prognosis of treatment is favorable. The number of complications does not exceed 2%, and deaths during surgical treatment are approaching zero. The majority of patients (90%) have a good quality of life after treatment. They do not need to change their profession and lifestyle. It is important to get to a specialist in a timely manner and begin treatment of liver cysts. The prognosis of treatment also depends on which doctor performs the operation and with what experience.
Prevention of liver cysts
There are no methods of prevention. To avoid parasitic cysts in the liver, people should be aware of the existence of diseases such as echinococcosis and alveococcosis, and the importance of following sanitary and hygienic rules, especially in endemic regions. This includes full-fledged heat treatment of products, hand washing after contact with animals. You need to be careful when contacting wildlife and understand that unwashed berries that grow in the forest may have traces of animal feces with parasite eggs.
Cystic formations in the liver occur at the level of small bile ducts, which become clogged due to chronic inflammation or degenerative changes (often occurs with age). Bile accumulates in the ducts, it becomes more and more, which leads to the appearance of formation.
There is also such a disease as "polycystic liver disease". This is a congenital and genetically determined disease in which the entire liver is affected. In most cases, cysts appear in the kidneys. As the disease progresses, liver failure may develop, in which case liver transplantation is required.
Reasons
Liver cysts are often associated with the ingestion of parasites. Echinococcosis is a parasitic disease that is transmitted through dogs in endemic regions engaged in animal husbandry, however, helminth eggs can also enter the body through poorly processed foods. People who neglect hygiene are at risk. As a result, echinococcal cysts of the liver occur. Worm eggs enter the intestines, and from there they enter the liver, where they begin to develop in a certain way. In the liver, they form a cyst, causing echinococcosis. Parasites from the liver can migrate to other organs.
Alveococcosis is a disease similar in nature to echinococcosis, but it is transmitted from foxes and martens that live in forests or on farms. Parasites also enter the human body if you do not wash your hands after contact with an animal or eat unwashed wild berries that have parasite eggs in the feces of wild animals. Hunters or workers of forestry and fur farms often encounter such cysts.
Parasitic cysts are often complicated by suppuration of cavities. Formations can rupture and cause anaphylactic shock and peritonitis, break through from the liver into the bile ducts, causing mechanical jaundice and cholangitis. They can also break through the diaphragm into the bronchial tree, causing breathing problems.
Rehabilitation after operations at the EMC
- If the liver cyst was removed using a low-traumatic laparoscopic method, rehabilitation takes no more than 2-3 days
- On the same day after the operation, the patient can move around the ward on his own, and be discharged from the clinic after 2-3 days
- After major surgeries, rehabilitation can take up to 10 days.: the more complicated the disease, the higher the risk of postoperative complications, so doctors monitor the patient longer and eliminate them in a timely manner in case of postoperative problems
- In order for surgical treatment to be as effective and comfortable as possible for the patient, the EMC uses a fast track strategy – accelerated rehabilitation.
