Simple liver cysts

Simple cysts are not inherited and unrelated to polycystic liver disease (see page 11) in which many more cysts are present. They are estimated to affect between 1% and 2.5% of the population. They affect all ages, but occur more frequently in the population as age increases.

Simple cysts usually have no symptoms. Larger cysts may occasionally cause some dull pain and/ or swelling in the upper right hand side of your abdomen, an area referred to as the ‘right upper quadrant’. Jaundice (yellowing of the skin and whites of the eyes), which is often caused by bile duct obstruction, is rare.

To diagnose simple liver cysts medical staff may record your medical history and carry out a physical examination. An ultrasound or CT scan of your abdomen may also be carried out.

Simple liver cysts generally do not require treatment unless they become large enough to cause pain.

To reduce their size, doctors can remove the fluid from the cyst. They do this by inserting a needle through the skin under X-ray guidance, and withdrawing (aspirating) the fl uid. However, the fluid will usually refi ll the cyst. To help stop this, after the fluid has been taken out, doctors may inject a substance into the cyst to help stick the walls together. This substance is called a sclerosant. A similar technique involves removing part of the wall of the cyst, called laparoscopic de-roofing.

Therefore, after drainage a sclerosant (such as alcohol) may be injected into the cyst in an attempt to ‘stick the walls together’ and prevent the cyst from refilling with fluid. (This is the reason why de-roofing is performed – to stop the cyst simply refilling with fluid).

As in endoscopy, laparoscopy uses a flexible fibre optic tube with a tiny camera and a light on the end (laparoscope). This is inserted into your abdomen through a small cut in your skin (keyhole). This procedure is performed under a general anaesthetic.