Hepatic Symptomatic Cysts: Report Of 4 Cases

摘要

Hepatic biliary cysts are congenital formations that are most often asymptomatic. Their diagnosis is easy with ultrasound and CT scans when they are simple. The treatment is only for symptomatic cysts. The aim of our study was to report our experience regarding the diagnosis and management of symptomatic hepatic cysts by relying on four cases diagnosed in the Department of General Surgery at Aristide Le Dantec Hospital.In 2009, there were 4 women consulting for abdominal mass and/or pain. The diagnosis of a simple hepatic cyst had been made on ultrasound and/or CT scan with negativity at anti-amebic and hydatid serology. Laparoscopic fenestration was performed on 3 patients and cystectomy on one. Histology confirmed the diagnosis, and no recurrence was noticed after 1 year follow-up. Introduction Hepatic biliary cysts are congenital formations that are most often asymptomatic. Their diagnosis is easy with ultrasound and CT scans when they are simple. Complicated, they can be confused with tumor lesions or parasites. The treatment is only for symptomatic cysts. The aim of our study was to report our experience regarding the diagnosis and management of symptomatic hepatic cysts by relying on four cases diagnosed in the Department of General Surgery at Aristide Le Dantec Hospital. Cases report Patient 1: A 54-year-old female patient with no significant history consulted because of pain in the right upper quadrant lasting for months associated with nausea. On examination, she presented a good general condition with colored mucous membranes and was anicteric. A firm insensitive mass was palpated in the right upper quadrant. Amebic and hydatid serologies were negative. The liver function was normal. The abdominal scan objectified a cyst of 15cm on segments II, IV and VIII juxta-hilar with portal rolling and duodenopancreatic and vesicular compression (Figure 1). On laparoscopic exploration, a cyst of about 15cm from the left lobe of the liver with multiple adhesions was found. She received a paracentesis followed by fenestration and an omental flap in the cystic cavity. The wall of the prominent dome was removed within a surgical glove (Figures 2, 3).