Minimally invasive management of hepatic cysts: indications and complications

D Vardakostas, C Damaskos, N Garmpis, E Antoniou, K Kontzoglou, G Kouraklis, D Dimitroulis, Christos Damaskos
OBJECTIVE: Liver cysts are divided into congenital and acquired. Congenital cystic lesions include polycystic liver disease, simple cysts, duct related and ciliated hepatic foregut cysts. Acquired cystic lesions are divided into infectious and non-infectious. The infectious cysts are the hydatid cyst, the amoebic abscess , and the pyogenic abscess, whereas the non-infectious cysts are neoplastic cysts and false cysts. While modern medicine provides a lot of minimally invasive therapeutic
more » ... therapeutic modalities , there has emerged a pressing need for understanding the various types of liver cysts, the possible minimal therapeutic options along with their indications and complications. We aim is to clarify the role of minimally invasive techniques in the management of hepatic cysts. MATERIALS AND METHODS: A literature review was performed using the MEDLINE database. The search terms were: liver cyst, minimally invasive, laparoscopic, percutaneous, drainage and fenestration. We reviewed 82 En-glish language publications articles, published until October 2017. RESULTS: Minimally invasive management of liver LC is an emerging field including many therapeutic modalities ranging from the per-cutaneous aspiration of pyogenic abscesses to laparoscopic hepatectomy for hepatic cystade-nomas. The most used techniques are percuta-neous drainage, laparoscopic fenestration, and laparoscopic hepatectomy. CONCLUSIONS: The application of the various minimally invasive approaches, as well as their indication and complications, depend on the type of the cystic lesion, its size and its position in the liver. Percutaneous drainage is mostly used in simple cysts, hydatid cysts, pyogenic abscesses and bilomas. Laparoscopic fenestra-tion is mostly used in simple cysts and polycys-tic liver disease. Finally, laparoscopic hepatec-tomy is mostly used in polycystic liver disease, hydatid cysts, and cystadenomas.