Hepatic cysts are a relatively common benign disease of the liver, commonly referred to as “blisters” in the liver. They can be classified as parasitic or non-parasitic, the latter being classified as congenital or retained. Except for a few patients from pastoral areas or with a history of exposure to epidemic worms who may be parasitic, most patients with clinical liver cysts are either retained or congenital. The causes of hepatic cysts are generally considered to be as follows: 1. Retained hepatic cysts: caused by increased secretion of some bile ducts in the liver due to inflammation, edema, scarring or stone obstruction, or bile retention, mostly single; 2. Congenital hepatic cysts: caused by developmental disorders of intrahepatic bile ducts and lymphatic ducts during embryonic life, or cholangitis during fetal life, occlusion of small intrahepatic bile ducts, proximal cystic enlargement and degeneration of intrahepatic bile ducts. They are mostly multiple and are often accompanied by renal cysts. Liver cysts grow slowly and most patients have no obvious symptoms and are often detected by ultrasound examination. However, when the cyst grows to a certain extent, it can compress the surrounding normal liver tissue and adjacent organs (such as stomach, duodenum and colon) and cause symptoms such as fullness after eating, poor appetite, nausea, vomiting, discomfort and vague pain in the right upper abdomen. A few patients may develop acute abdomen due to cyst rupture or intracapsular hemorrhage, etc. Obstructive jaundice caused by compression of the bile duct is less common. Sudden right upper abdominal cramps may occur in case of torsion of the cyst with tip. If infection occurs in the cyst, the patient may have symptoms such as chills, fever and leukocytosis. So do liver cysts need surgical treatment or not? We need to take a comprehensive consideration. Small cysts without symptoms require only regular review and usually do not require surgery. Larger cysts with the above mentioned symptoms can be treated surgically. Commonly used methods include: cyst aspiration under ultrasound guidance; dissection or laparoscopic excision of part of the cyst wall and opening the cystic cavity to the abdominal cavity after aspiration of the cystic fluid, which is called cyst windowing or debulking and is suitable for general cysts; for patients with complications of infection, intracapsular bleeding or cystic fluid stained with bile, drainage can be placed after windowing or perforated tube drainage; cysts with marginal parts of the liver and cysts with tips protruding into the abdominal cavity are suitable for cystectomy. Cystectomy is indicated for cysts in the marginal part of the liver, with the tip protruding into the abdomen; lobectomy or partial hepatectomy is considered for huge liver cysts.