Help
Subscribe


GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy

 26 May 2018

Advanced search
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Management of large hepatic cystic lesions in adults

Research in July's Journal of the American College of Surgeons reports on the occurrence and management of large cystic lesions of the liver

News image

fiogf49gjkf04

Researchers from Miami, Florida, USA, performed a retrospective review of adults diagnosed with large hepatic cystic lesions, over a 15-year period.

78 patients with lesions greater than 4 cm were identified at a single institution. Those with polycystic disease and abscesses were not included.

The lesions were classified as simple cysts (n = 57), hepatobiliary cystadenomas (n = 8), echinococcal cysts (n = 8), or hepatobiliary cystadenocarcinoma (n = 1). The precise diagnosis could not be ascertained in 4 patients.

The mean size of the lesions was 12.1 cm (range, 4 to 30 cm). Simple cysts were found to be 6 times more prevalent in women.

Percutaneous aspiration of 28 simple cysts resulted in recurrence in 100% of the cases, within 3 weeks to 9 months.

48 patients were treated surgically by wide unroofing or resection (laparoscopically in 18). This resulted in low recurrence rates (11% for laparoscopy and 13% for open unroofing).

4 of the 8 patients with echinococcal cysts were symptomatic. All were treated by open resection, after irrigation of the cavity with hypertonic saline. The researchers found that there was no recurrence during a follow-up period of 2 to 14 years.

Appropriate management of lesions:
Simple cysts:
laparoscopic unroofing
Echinococcal cysts:
open resection
Hepatobiliary cystadenomas:
open resection
Journal of the American College of Surgeons

Hepatobiliary cystadenomas occurred more commonly in women (female:male, 7:1) and in the left hepatic lobe (left:right, 8:0). 7 of the 8 were found to be multiloculated. All were treated by open resection, with no recurrence, and none had malignant changes.

Cystadenocarcinoma was diagnosed in a 77-year-old man, and was treated by left hepatic lobectomy.

Dr Arie Regev, of the Center for Liver Diseases, Miami, said on behalf of fellow authors, "Large symptomatic simple cysts invariably recur after percutaneous aspiration. However, laparoscopic unroofing can be successfully undertaken, with a low recurrence rate.

"Open resection, after irrigation with hypertonic saline, is a safe and effective treatment for echinococcal cysts."

"Hepatobiliary cystadenomas have predilection for women and for the left hepatic lobe. Malignant transformation is an uncommon, but real, risk.

"Open resection is a safe and effective treatment for these type of lesions, and is associated with a low recurrence rate," it was concluded.

J Am Coll Surg 2001; 193 (1): 36-45
04 July 2001

Go to top of page Email this page Email this page to a colleague

 25 May 2018 
Colorectal cancer–specific mortality
 25 May 2018 
Technology to increase colorectal cancer screening
 25 May 2018 
Post‐operative complications in elderly IBD
 24 May 2018 
Patient-reported outcome measures in IBD trials
 24 May 2018 
Alcohol consumption and outcomes in drug-induced liver injury
 24 May 2018 
Precision medicine for tumors
 23 May 2018 
Management of perianal fistulas in Crohn’s disease
 23 May 2018 
Cardiovascular risk in diabetes mellitus with NAFLD
 23 May 2018 
High body mass index is and ulcerative colitis
 22 May 2018 
Worldwide H.pylori prevalence
 22 May 2018 
PPI and risk of stroke
 22 May 2018 
Online tool predicts bowel dysfunction severity prior to anterior resection
 21 May 2018 
Depressive symptoms in IBD youth
 21 May 2018 
PPI use and cognitive decline
 21 May 2018 
Fecal incontinence and quality of life in IBD
 18 May 2018 
Esophageal dilatation in clinical practice 
 17 May 2018 
IBD and later extraintestinal manifestations
 17 May 2018 
Repeat stool DNA testing
 17 May 2018 
IBS and chronic fatigue following GI infection
 16 May 2018 
Factors associated with fecal incontinence
 16 May 2018 
Diagnostic delay in Crohn's disease
 16 May 2018 
Cardiovascular risk in diabetes mellitus with NAFLD
 15 May 2018 
Guidelines for management of Crohn's
 15 May 2018 
Hep B in the Grey Zone
 15 May 2018 
New therapies for CDI
 14 May 2018 
Blood test for the diagnosis of fibrotic NASH
 14 May 2018 
Outcomes at bariatric centers of excellence
 14 May 2018 
Management of perianal fistulas in Crohn’s
 11 May 2018 
Detection of undiagnosed celiac disease
 11 May 2018 
Alcohol consumption and drug-induced liver injury
 10 May 2018 
Colorectal cancer screening
 10 May 2018 
Fibrosis in patients with chronic hepatitis B
 09 May 2018 
Fecal incontinence
 09 May 2018 
Health problems and IBS
 09 May 2018 
Esophageal dilatation in clinical practice 
 07 May 2018 
Omitting antibiotics in uncomplicated acute diverticulitis
 07 May 2018 
Health problems and IBS
 07 May 2018 
Assessment of diminutive colorectal polyps
 04 May 2018 
National Institutes of Health workshop and obesity
 04 May 2018 
Factors associated with fecal incontinence
 04 May 2018 
Colorectal cancer screening and ethnic inequities
 03 May 2018 
Gastrointestinal ultrasound in IBD
 03 May 2018 
Ultransonography in postsurgical recurrence in Crohn's
 02 May 2018 
Symptom assessment in cirrhotic ascites
 02 May 2018 
Hep C antiviral treatment and liver cancer risk
 02 May 2018 
Chronic Hep B
 01 May 2018 
European guidelines on pancreatic cystic neoplasms
 01 May 2018 
Interferon‐free regimens in Hep C
 01 May 2018 
Age at IBD onset and extraintestinal complications
 30 April 2018 
Formula for preterm infants
 30 April 2018 
Primary antibiotic resistance and sequential therapy for H. pylori
 27 April 2018 
Eastern and western practices for endoscopic resection of colorectal lesions
 27 April 2018 
Anxiety scale for chronic esophageal disease
 27 April 2018 
Disease activity in eosinophilic esophagitis
 26 April 2018 
Obesity and physical activity in diverticulosis
 26 April 2018 
Primary sclerosing cholangitis in the USA
 25 April 2018 
Aspirin and pancreatic cancer
 25 April 2018 
Central mediators of irinotecan-induced steatohepatitis
 25 April 2018 
Neuroimaging in Hep C
 24 April 2018 
Scoring system identifies cancer risk in Barrett's

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2018 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us