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Abstract: Liver cysts do not usually require surgical treatment unless the cyst is very large. This 31-year-old young female patient visited our hospital with the clear purpose of surgical treatment of liver cysts. After abdominal ultrasound examination, it was confirmed that the size of liver cysts in this patient was about 6 cm, and surgery could be considered, so the condition was basically cured by laparoscopic cyst wall resection treatment of liver cysts under surgery.
Basic information】Female, 31 years old
Type of disease】Hepatic cyst
Hospital】The First Hospital of Jilin University
Date of consultation】January 2021
Treatment plan】Surgical treatment (laparoscopic resection of liver cysts and cyst wall)
Treatment Period】7 days of inpatient treatment, 1 month of outpatient follow-up
Effectiveness】Cure of disease
I. Initial consultation
Patient Ms. Li, 31 years old, was asked about her condition and was told that the purpose of this hospitalization was mainly to remove the liver cyst. I was a little surprised to learn that liver cysts are usually relatively simple cysts and do not require surgery unless they are particularly large. Patient’s self-report: recent upper abdominal discomfort, no obvious past history, no history of surgery, no hypertension, diabetes, coronary heart disease, hepatitis B, hepatitis C, tuberculosis, etc. Since this is a slow diagnosis of liver cysts, after understanding the condition the patient was prescribed a detailed examination before surgery.
II. Treatment history
The tests I prescribed to the patient included: CT of liver, biliary and pancreatic, tumor markers, liver function, routine blood count, electrocardiogram, and cardiac ultrasound, etc. The results were not abnormal. The patient’s liver cyst was located in the right lobe of the liver against the parietal area of the diaphragm, and the volume was also about 6 cm, with local exophytic growth, and no obvious cyst wall thickening or tumor manifestation was found, which is generally a simple liver cyst. So I informed the patient and family that the surgical treatment for hepatic cysts is generally divided into two cases. If the cyst is found to be a simple hepatic cyst during surgery, the cyst can be opened and drained, but if the cyst wall is found to be thickened and nodular, and if the pathology suggests a cystadenoma, complete resection of the cyst and partial resection of the liver may be required.
The patient and family were very understanding and cooperative, and the patient was then explored laparoscopically in the operating room under general anesthesia, where the cyst wall was found to be regular and the local tissue was slightly thick. However, after taking the pathology, the rapid pathology suggested that there was a local cystic adenoma component, so the patient’s family was told that this situation might require an extended surgery and the whole cyst wall needed to be removed, and the patient and family were very hesitant.
III. Treatment results
The patient’s postoperative recovery was very smooth. After the abdominal drainage tube was removed on the second postoperative day, there were no symptoms such as fever, abdominal pain, or complications such as bleeding or biliary fistula, and the patient started to resume eating on the third day. After about 7 days of hospitalization, the patient’s mental state was significantly better than before, the epigastric distension and pain disappeared, his mood changed from anxiety to optimism and cheerfulness, and the cyst disappeared, there was no fluid in the abdominal cavity, and the liver function transaminase index gradually returned to normal, so the patient was discharged.
IV. Notes
We are glad that the patient went to the hospital in time after knowing that he had liver cyst and got good treatment result. However, it is still necessary to advise the patient to actively do postoperative monitoring, pay attention to the review of liver function and abdominal CT to clarify the recovery of the abdominal cavity and to clarify whether there is any recurrence of cysts. In addition, we should pay attention to diet and work and rest in our life, diet with high protein and high nutrition food, avoid smoking and alcohol, maintain good work and rest habits, avoid staying up late and straining, ensure sufficient sleep, and participate in physical exercise appropriately, which will help the body recover as soon as possible.
V. Personal insight
Liver cysts in the clinic, the vast majority refers to simple cysts, is a class of benign diseases, in the liver cysts larger volume to timely diagnosis, early diagnosis, early treatment, like this patient. Not only can we improve the quality of survival and avoid adverse consequences. However, it should also be noted that liver cysts also have the possibility of cystic tumor or cystic adenocarcinoma, which requires our special attention in clinical treatment. The rapid intraoperative pathology of this patient suggests a local cystadenoma component, so complete cyst wall resection or partial hepatectomy must be done to prevent cancer.