Investigating optimal treatments for nonparasitic hepatic cysts, Mazza et al analyzed the outcomes associated with various surgical procedures used to treat these lesions. [17] The study involved the evaluation of data from 131 patients (78 with simple cysts, 53 with PCLD) treated at an institution where the authors practiced.
Mazza et al reported that laparoscopic unroofing or marsupialization (66 patients) completely relieved symptoms from either simple lesions or PCLD, with the procedure's morbidity, mortality, and recurrence rates being, respectively, 2%, 0%, and 2% for patients with simple cysts, and 25%, 0%, and 5% for patients with PCLD. [17] For infected cysts, the investigators' procedure of choice was percutaneous drainage (19 patients), the morbidity, mortality, and recurrence rates for this procedure being, for simple cysts, 0%, 0%, and 75%, respectively, and for PCLD, 0%, 0%, and 20%, respectively
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Histology demonstrating biliary epithelium lining simple cyst.
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Ultrasonographic appearance of large simple hepatic cyst.
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Computed tomography (CT) scan appearance of large hepatic cyst.
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Computed tomography (CT) scan of polycystic liver disease curiously limited to right liver.
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Hepatic cysts. Sagittal magnetic resonance imaging (MRI) reconstruction in patient with large echinococcal cyst; note daughter cysts in interior.
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Computed tomography (CT) appearance of biliary cystadenoma.
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Resection of involved liver in polycystic liver disease.
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Laparoscopic view of initial hepatic cyst puncture, before unroofing. Lesion is located high in right liver near the diaphragm.
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Laparoscopic view of beginning of unroofing of large simple hepatic cyst near dome of right liver.
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Drawing of final result of laparoscopic unroofing of a large simple hepatic cyst in right liver.
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Initial penetration of hepatic cyst with drainage of cyst fluid.
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Unroofing of hepatic cyst.
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Omentum sutured to excised margin.