Liver cysts are cystic diseases that occur in the liver.
Usually there are no obvious symptoms, but when the cysts are too large, abdominal pain and distension may occur, and some of them may be palpable abdominal mass.
They are mainly congenital, but also associated with inflammation, trauma and parasitic infection in the liver.
Most of them do not need special treatment, but surgery is feasible when necessary.
What are Liver Cysts?
Definition
Liver cysts are cystic, mostly benign lesions that occur in the liver.
Cysts may be isolated, confined to one lobe or diffusely involve the entire liver, or they may be multiple, with cysts of varying size, which may contain fluid or solid cells.
Simple liver cysts: also classified as solitary and multiple.
Polycystic liver disease: also known as polycystic liver disease.
Morbidity
Congenital hepatic cysts are the most common in clinical practice. The prevalence of congenital hepatic cysts is reported to be 2.5% to 18%.
Polycystic liver disease is less common, with foreign autopsies reporting 0.05% to 0.13%; 83% to 94% of those with autosomal dominant polycystic kidney disease present with polycystic liver disease, and the majority of them become symptomatic after the age of 35.
Parasitic liver cysts (mainly hepatic echinococcosis), is a zoonosis. In China, it is mostly found in the northwestern regions with developed animal husbandry.
Questions you may be concerned about
What are the dangers of liver cysts?
Large localized cysts with compression symptoms can appear after eating a feeling of fullness, nausea and vomiting, epigastric pain and other symptoms, serious cases can cause rupture of the cysts, ascites and other complications, the need for timely medical attention.
Cyst rupture and hemorrhage: larger liver cysts may rupture and bleed, and the patient may suddenly experience abdominal pain, pallor, shortness of breath and other symptoms.
Ascites and liver failure: Ascites and liver failure may occur in the late stage of polycystic liver causing serious damage to liver function.
Do liver cysts need treatment?
Most of the liver cysts grow slowly and are small in size. If there are no uncomfortable symptoms, they usually do not need special treatment and can be examined regularly.
However, if the cysts are large and localized pressure symptoms appear, they can be treated by surgery or puncture, and usually have a better prognosis. When severe polycystic liver disease causes liver failure, liver transplantation and other treatments are required.
What kind of Chinese medicine can eliminate liver cysts?
Whether or not liver cysts can be eliminated depends on the specific clinical situation, but traditional Chinese medicine can improve the symptoms of chest pain and distension, and discomfort in the liver area.
Liver cysts belong to the category of dystocia in traditional Chinese medicine, which is mostly caused by the evil of dampness and heat, and emotional and emotional injuries. The medicines used are mainly to ease the liver and relieve depression, activate blood circulation, strengthen the spleen and promote dampness, and relieve pain, such as: moneywort, haijinsha, jianneijin, neem, descending incense, tulip, yanhuisuo, and tai zi ginseng.
Chinese medicine can relieve discomfort and control the development of liver cysts, and the specific medication should be prescribed by the doctor.
Causes
Causes
Congenital factors
Abnormalities in embryonic development
Most of them lead to the development of simple hepatic cysts, the details are still not very clear, there are the following two views.
Embryonic intrahepatic bile ducts or lymphatic ducts developmental disorders, or intrahepatic vagal bile ducts formation, and eventually dilated into cysts.
Cholangitis caused by intrahepatic infection during embryonic period, resulting in atresia of small intrahepatic bile ducts, distal dilatation or degeneration of intrahepatic bile ducts, and localized blockage to form cysts.
Genetic mutation
Genetic mutations cause abnormal development of the intrahepatic bile ducts during the embryonic period, mainly resulting in hereditary polycystic liver disease.
It is closely related to autosomal dominant polycystic kidney disease.
Inflammation or stones in the bile ducts of the liver
Inflammation of the intrahepatic bile ducts.
Bile duct stone obstruction.
Tumors.
Includes teratomas, cystadenomas, hepatic cystadenomas, hepatic cystadenocarcinomas, etc., which are relatively rare.
Trauma
Open injury: such as accident or surgery that causes sharp objects to puncture or scratch the liver, resulting in liver injury.
Closed injury: e.g. crushed or hit by the body, resulting in liver injury.
Parasitic infection
Mostly caused by contact with or accidental ingestion of echinococcus tapeworm eggs.
Cystic larvae of the fine-grained echinococcal tapeworm, which causes fine-grained echinococcosis.
Cystic larvae of the vesicular echinococcus tapeworm, causing vesicular echinococcosis.
Pathogenesis
Embryonic developmental abnormalities
The exact mechanism has not been clarified.
It is usually thought to originate in the biliary tree, and since simple liver cysts are not hereditary diseases, genomic germline mutations are generally not present.
It has also been suggested that somatic mutations occurring in cholangiocytes may be an important mechanism in the development of simple hepatic cysts.
Genetic mutations
Two groups of genes are involved, PKD1 and PKD2, SEC63 and PRCKSH.
PKD1 and PKD2 determine the development of polycystic kidney disease combined with polycystic liver disease.
SEC63 and PRCKSH determine the development of isolated polycystic liver disease.
Bile duct inflammation
Inflammation, edema and stones in the bile ducts lead to increased bile secretion, which in turn leads to bile retention causing cystic dilatation of the bile ducts and formation of cysts.
Tumors
Most often, tumor cells invade the bile ducts and cause retention cysts.
The pathogenesis of hepatic cystadenoma and hepatic cystadenocarcinoma has not been clarified, but studies suggest that they mainly originate in the biliary tree.
Trauma
Trauma to the liver may result in hematoma, bile retention, or tissue necrosis, which may lead to cystic cavity formation.
Parasitic infection
After contact with or accidental ingestion of food or water containing eggs of the tapeworm Echinococcus granulosus, Hexacoccus granulosus is released in the upper gastrointestinal tract and attaches to, and pierces, the intestinal wall and enters the hepatic portal vein system.
The tapeworm resides in the liver and can grow and multiply, which in turn forms slow-growing cysts in the liver.
Risk factors
Congenital abnormalities of bile duct development.
Trauma to the liver and gallbladder.
Hepatobiliary surgery.
Parasites in the liver.
Have hepatitis or carry the hepatitis B virus.
Have polycystic kidney disease or have someone in your family with polycystic kidney disease.
Symptoms
Main Symptoms
Liver cysts usually have no obvious symptoms, and are most often detected during imaging tests or other abdominal procedures. Parasitic liver cysts tend to have systemic symptoms, and may have corresponding symptoms when they are infected or penetrate the surrounding tissues; non-parasitic liver cysts may have compression symptoms when they are large in size.
Fullness after eating, loss of appetite, nausea, vomiting.
Discomfort in the right upper abdomen, may have hidden pain.
A mass may be palpable in the right upper abdomen that moves up and down with breathing.
Parasitic liver cysts may also present with bloody sputum and itching.
Complications
Liver cyst infection
Fever, which occurs when liver cysts are co-infected.
Pain, mainly in the upper abdomen, radiating to the back of the right posterior shoulder.
Bleeding or torsion of the cyst
Acute, severe pain in the upper abdomen.
Bile duct compression or cholangitis
Jaundice, more rarely.
Discomfort or distension in the epigastrium, or colicky episodes, worsened by eating greasy food.
Venous thrombosis
Mostly due to compression of the inferior vena cava, extremely rare.
Symptoms depend on the location and degree of obstruction and the state of collateral circulation. Mild obstruction may be asymptomatic.
Severe obstruction may manifest as swelling of the lower extremities (exacerbated by exercise), varicose veins in the chest and abdominal wall, renal venous hypertension (low back pain, enlarged kidneys), inferior vena cava, portal hypertension (hepatosplenomegaly, ascites, vomiting of blood, black feces), and so on.
Cystic echinococcosis
Mainly seen in parasitic liver cysts.
Complicated bacterial infection: symptoms are similar to those of liver abscess, and high fever and right upper abdominal pain may be present.
Cyst rupture
If the cyst ruptures into the biliary tract, biliary colic (severe pain in the right upper abdomen), jaundice (yellowing of the skin) and urticaria (itching of the skin and the appearance of windburns) of varying severity may occur; in severe cases, acute suppurative obstructive cholangitis may occur, which may be characterized by severe abdominal pain, chills, high fever, jaundice, or even shock (cyanosis, shortness of breath, palpitation, restlessness, indifference, lethargy, fainting, etc.).
If the cyst breaks into the abdominal cavity, abdominal pain and signs of peritoneal irritation (pressure, rebound pain and muscle tension) may occur, and absorption of cystic fluid by the peritoneum may cause urticaria and shock.
Cysts can also break into the chest, kidney, colon or renal pelvis and cause various symptoms.
Rupture of the cyst can lead to implantation spread, causing secondary echinococcosis.
Multi-compartmental or vesicular echinococcosis
Direct infiltration destroys the liver and symptoms appear later.
The main manifestation is progressive hepatic enlargement, and a hard, nodular, uneven hepatic surface can usually be palpated under the costal margins.
In advanced stage, the aggravation of liver lesions may be accompanied by liver function impairment or even cirrhosis, with the appearance of jaundice, ascites, portal hypertension or secondary lung or brain metastases.
Consultation
Department
General Surgery
Routine physical examination of the abdomen ultrasound suggests liver cysts, or abdominal distension, abdominal pain, abdominal mass and other symptoms, it is recommended to consult the doctor in time.
Preparation
Consultation: Registration, Preparation of Information, Frequently Asked Questions
Tips for medical treatment
Before going to the doctor, try to keep a record of the symptoms you have experienced and how long they have lasted.
Preparation Checklist
Symptom list
Pay particular attention to the time of onset of symptoms, special manifestations, etc.
What tests were done to detect the liver cyst?
Were there any symptoms such as abdominal pain, bloating, etc.?
When did it appear?
What tests and treatments have been done?
List of medical history
Has there been any trauma to the abdomen?
Has there been any parasitic disease? Any history of pastoral living?
Any viral hepatitis, lung infections, or other diseases?
Has anyone in the family had similar symptoms?
Checklist
Test results from the last six months, which can be brought to the doctor’s office
Abdominal ultrasound, CT, MRI
Blood tests
Liver Function
Immunological examination
Pathologic examination
Diagnosis
Diagnostic basis
Medical history
History of liver cysts.
A history of polycystic kidney disease or a family history of polycystic kidney disease.
History of hepatobiliary trauma or surgery.
Living in a pastoral area with a history of contact with animals such as sheep and cattle.
Have a history of hepatitis or carry hepatitis B virus.
Clinical manifestations
Symptoms
There are no obvious symptoms in the early stage, but abdominal pain and distension may occur when the cysts are too large, and some of them may be palpable as an intra-abdominal mass.
Physical examination
Mainly abdominal examination, including the size, number and location of the mass, whether the liver is enlarged, abdominal pain.
For larger hepatic cysts, the right upper abdominal mass can be palpated, the surface is smooth and tough, and the mass moves up and down with breathing.
There is no obvious pressure pain, and there may be tenderness when combined with infection.
Observe the skin for jaundice.
Imaging examination
The diagnosis of hepatic cysts mainly relies on imaging examinations.
Ultrasonography
Purpose: To understand the morphology and structure of the liver and whether there are any pathological changes.
Significance: the preferred examination method. Ultrasonography shows that the cysts are round or oval non-echoic areas, with thin walls, smooth edges, clear borders with surrounding tissues, and enhanced echogenicity thereafter.
Precautions
Fasting and water fasting are required 8 hours before the examination.
During the examination, you need to take off your heavy coat and leave only close-fitting clothes such as shirts, undershirts and sweaters.
Follow the doctor’s instructions to lie down during the examination and do not move around.
After the examination, you can have normal diet and activities. If you have frequent hidden pain in the abdomen, it is better to rest more and do less activities.
CT examination
Purpose: To understand the shape and structure of the liver and whether there are any pathological changes.
Significance
Generally, the cysts are seen to be round, with clear margins and uniform density.
If there is intracystic hemorrhage, secondary infection, etc., thick wall and increased density within the cyst can be seen.
Parasitic liver cysts with uneven density on CT are seen to have thick walls and thicker intervals within the cysts, which are mostly calcified and appear as striated, massed or irregular.
Precautions
Fasting for 6 hours before the examination is required.
Remove all metal objects from the body before the examination.
Enhanced CT is contraindicated for those who are allergic to contrast media.
MRI examination
Purpose: To understand the morphology and structure of the liver and whether there are pathological changes.
Significance: It is of high value for the diagnosis of the disease, especially when cystic occupations cannot be fully determined by other examinations.
It presents as a round or ovoid occupancy in the liver with clear borders.
Magnetic resonance diffusion imaging is important in identifying liver cysts.
Precautions: Those with nerve stimulators, metal teeth, pacemakers, artificial metal valves, foreign bodies in the eyeballs, and those with early pregnancy should inform the doctor about the situation in advance.
X-ray examination
Purpose: To understand the morphology and structure of the liver and whether there are any pathological changes.
Significance: Elevation of the diaphragm and displacement of the stomach under pressure can be seen when the cyst is huge.
Precautions
Special groups, such as infants, young children, pregnant women, should be cautious of X-ray examination.
Remove metal objects from the chest before the examination, such as necklaces around the neck and undergarments with metal braces.
Radionuclide imaging
Objective: To understand the morphology, structure, blood flow, function and metabolism of the liver.
Method: Liver scanning with the help of radionuclides 198Au, 131I, etc.
Significance: It helps to determine whether there is a space-occupying lesion in the liver and is helpful in identifying whether the cyst is intrahepatic or extrahepatic. It presents as a round or large patchy radiolucent defect with neat margins or sparing.
Precautions
Special populations, such as pregnant women, should exercise caution.
Before the examination, fast for more than 6 hours, you can drink water, but not containing substances such as sugar.
Before the examination, avoid high-intensity exercise.
During the examination, metallic objects, such as necklaces, earrings, movable dentures, metal buttons, etc., need to be removed.
Others
Such as renal secretion imaging, renal arteriography examination.
Laboratory Tests
Routine blood test
Purpose: To check the changes of blood cells (red blood cells, white blood cells, platelets) and hemoglobin.
Significance: Can be used to determine the presence of infection.
Precautions: Fasting is not required before the test.
Liver Function Test
Purpose: To understand the metabolic function of the liver.
Significance: Abnormal liver function may occur when large cysts or polycystic liver compresses the bile ducts or when combined with infection and inflammation.
Indicators reflecting bilirubin metabolism and cholestasis mainly include total bilirubin (TBil), direct and indirect bilirubin, urobilirubin, urobilinogen, blood bile acids (TBA), γ-glutamyl transpeptidase (γ-GT) and alkaline phosphatase (ALP).
Note: Fasting is required before the test.
Immunological examination
Purpose: To check whether there are corresponding antibodies in the serum.
Methods: Including enzyme-linked immunosorbent assay (ELISA), indirect erythrocyte agglutination test (IHA), immunoblotting technique (WB) and intradermal test for Echinococcus granulosus (Casoni test).
Significance: To assist in the diagnosis of hepatic echinococcosis and cystic tumors.
Precautions: Please follow your doctor’s instructions.
Pathologic examination
Purpose: To understand the pathologic changes of the lesion.
Significance
Hepatic echinococcosis: it can clarify the diagnosis and identify the echinococcal cyst wall, cysts, proto-cephalic nodes or head hooks in surgical biopsy material, resected lesions or excretions.
Cystic tumor: a definitive diagnosis can be made and staging determined.
Precautions: After surgery, pay attention to keep the wound clean and avoid infection.
Others
Laparoscopy: it can observe the lesion under direct vision and puncture for cytological examination and puncture fluid extraction. It is a traumatic examination and is suitable for difficult cases.
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Genetic testing: In cases where polycystic liver disease is suspected but family history is lacking, genetic testing is indicated to differentiate from multiple simple liver cysts.
Differential diagnosis
Cysts that grow to a certain size and become compressive need to be differentiated from the following diseases
solid malignant tumor of the liver
Similarity: both may have abdominal pain and abdominal mass.
Differences: most of the tumors are low density or mixed density in CT scan, while better differentiated hepatocellular carcinoma can be isodense with irregular or lobulated margins; pathological examination can be differentiated.
Liver abscess
Similarity: both may present with high fever and abdominal pain.
Differences: liver abscess manifests as liquid occupancy, characterized as follows.
Most of them have symptoms of infection and poisoning, such as chills, high fever, nausea and vomiting.
CT examination shows edema bands around the abscess, and enhancement scan shows obvious strengthening of the abscess wall.
Ultrasound-guided diagnostic puncture to extract foul-smelling pus can confirm the diagnosis of bacterial abscess; chocolate-like pus can confirm the diagnosis of amoebic liver abscess.
Hepatic hemangioma
Similarity: It is more common in females, usually asymptomatic or with nausea, vomiting, epigastric discomfort and other compression symptoms.
Differences: Hepatic hemangioma can be seen in ultrasound with blood inflow into the tumor, and gradual enhancement can be seen in enhanced CT.
Congenital intrahepatic bile duct dilatation
Similarity: both may present with jaundice, accompanied by abdominal pain or palpable abdominal mass.
Difference: cysts caused by intrahepatic choledochotomy are connected to the bile ducts and can be differentiated by percutaneous hepatic puncture cholangiography or 99mTc nuclear scan.
Treatment
When liver cysts are small and asymptomatic, they usually do not need to be treated and regular review is sufficient.
For symptomatic liver cysts, the main reliance is on surgical treatment, among others.
Surgery
Non-parasitic liver cysts
If a large cyst causes symptoms, the following surgical methods may be used depending on the specific conditions.
Hepatic cyst enucleation
There are both open and laparoscopic approaches.
Indications
This method is preferred for single hepatic cysts with obvious symptoms, after exclusion of parasitic and neoplastic cysts and intrahepatic biliary dilatation.
Decompression and drainage of multiple hepatic cysts and isolated hepatic cysts without complications are generally more effective.
Contraindications
Traffic liver cysts, such as combined biliary fistula.
Hepatic cysts with complications such as infection and bleeding.
Severe organ dysfunction unable to tolerate surgery.
Laparoscopic surgery
Laparoscopy has been widely used in the treatment of hepatic cysts. The procedure is simple, less invasive (minimally invasive), and has a quick recovery.
Laparoscopic surgery should be used with caution for liver cysts that are deep, large and have complex anatomical locations.
Common complications are biliary fistula, bleeding, recurrence of the cyst, and severe ascites.
Percutaneous transluminal decompression
This method can be used in the preoperative preparation of large congenital cysts to avoid severe physiologic disturbances caused by sudden decompression after incision.
Simple puncture and fluid extraction and decompression can only be used as a temporary relief of compression symptoms, and has a high recurrence rate; for large cysts, drainage is preferred to gradually reduce the size of the cyst.
Radical resection
Cesarean cystectomy or hepatectomy for congenital hepatic cysts is now rare. Radical resection is more damaging to the body and should be chosen carefully.
Hepatic cysts with tips, combined with intracystic hemorrhage and chronic infection should be treated with hepatic cystectomy.
Multiple hepatic cysts with poor results of windowing surgery can be feasible lesions of liver segment or lobectomy.
If the location of cysts is deep, regular hepatectomy is feasible.
If malignant transformation of cysts is suspected and hepatic cystic adenocarcinoma is not excluded, partial hepatectomy or regular hepatectomy can be performed together with normal liver tissues around the cysts.
Internal drainage of cysts
It is suitable for simple hepatic cysts combined with biliary fistula and thicker cyst wall.
The liver cyst is anastomosed with the small intestine to realize the internal drainage of cystic fluid.
Generally, Roux-en-Y is performed, and anastomosis is used to prevent postoperative cyst reflux infection.
Hepatic artery embolization
Selective embolization of the hepatic artery can specifically embolize the blood supply of the cysts, so that the cysts can be shrunken and occluded, thus alleviating the symptoms and slowing down the disease process.
It is suitable for polycystic liver disease in which the cysts are relatively concentrated in the liver segments or lobes.
Liver transplantation
Suitable for those with extensive multiple total liver cysts and advanced liver failure with severe complications such as ascites, jaundice and portal hypertension.
Parasitic liver cysts
Hepatic cystic echinococcosis
Complete exfoliation of the external capsule
Indications: except for the echinococcus cysts are huge, the operation space is narrow, the cysts and the surrounding tissues are seriously adherent and can not be fully exposed, or it is difficult to find the “potential gap” between the cysts and the surrounding hepatic tissues, and the wall of the echinococcus cysts is too thin and easy to rupture, all the others are suitable and preferred to the external capsule intact debridement.
Disadvantages: Higher technical and instrumentation requirements. Moreover, forcible debridement of the echinococcus outer capsule close to the hepatic hilum and important vasculature is likely to injure the major bile ducts or blood vessels, resulting in serious complications.
Partial hepatectomy
Indications: Multiple echinococcal cysts confined to one liver segment or lobe; recurrent thick-walled echinococcal cysts combined with intracystic infection or hematogenous granuloma; bile leakage in the remnant lumen of the external capsule with a long period of time or repeated debridement without healing.
Disadvantages: The presence of the remnant cavity of the external capsule is prone to postoperative complications.
Subtotal resection of the external capsule
Indications: multiple surgeries, huge lesions and narrow operating space; lesions and the surrounding adhesion is tight and difficult to peel off; the cyst wall is thin and easy to rupture single cystic type, the gap is difficult to find the calcified cystic echinococcosis, especially when the echinococcal cysts are close to the main blood vessels of the hepatic hilum, the separation of the bile ducts is difficult.
Advantages: Significantly reduces surgical risk, shortens operative time, and reduces postoperative complications.
Modified endocystectomy for hepatic cystic echinococcosis.
Indications: All types of hepatic cystic echinococcosis whose general condition can tolerate anesthesia and surgery.
Disadvantages: susceptibility to refractory complications such as biliary fistulae and residual cavity infections, and risk of postoperative recurrence of hepatic cystic echinococcosis or dissemination of implants.
Percutaneous fine-needle puncture to induce cystic fluid surgery
Indications: inability to tolerate open surgery; objective previous surgery has caused adhesion between the liver surface and the abdominal wall, or it is not yet possible to diagnose the recurrence of echinococcus granulosus or the residual cavity of the single-cystic type of suspected patients.
Advantages: Less invasive, easier to perform, diagnostic intervention, recommended in countries and regions where surgery is not yet available.
Laparoscopic removal of hepatic cystic echinococcosis
Indications: single hepatic cystic echinococcosis located in liver segments Ⅲ, Ⅳ, V, Ⅵ; thickness of the outer cyst wall >3 mm; multiple hepatic cystic echinococcosis cysts confined to one liver segment or lobe close to the edge of the liver; good cardiac and pulmonary function, able to tolerate laparoscopic surgery.
Advantages: less trauma, less postoperative pain, shorter hospitalization and recovery time.
Liver transplantation: Allogeneic liver transplantation is performed when hepatic cystic echinococcosis lesions compress the second hepatic hilar, resulting in severe hepatic stasis, and when traditional treatments are ineffective in improving hepatic function, hypersplenism, portal hypertension, and peritoneal effusion, or when there is a risk of hepatic failure after autologous transplantation.
Hepatic vesicular echinococcosis
Radical resection is the method of choice.
Palliative surgery, local ablative therapy, liver transplantation, isolated hepatectomy and autologous liver transplantation are also options.
Postoperative care
Postoperative activities
Patients are often afraid to move around after surgery due to wound pain or fear. On the day of surgery, they should be encouraged to turn over in bed and assisted in passive limb movement in bed.
Appropriate activities can promote exhaustion on the one hand, and prevent venous thrombosis on the other.
After that, the patient can progress gradually: sitting up next to the bed, moving next to the bed, and moving down to the ground.
The activities should pay attention to the safety of the body.
Postoperative diet
After surgery, you should follow the doctor’s advice to start eating, from fat-free liquid diet (such as lotus root powder, rice soup, steamed egg custard, etc.) to low-fat semi-liquid diet (such as southern bean curd, congee with chopped vegetables, steamed fish puree, skimmed yogurt, etc.), and vegetables and fruits should be chopped up and cooked or squeezed into juices.
Others
Wounds with redness, swelling, hard nodules, pain or fever may be infected and require prompt medical attention.
Regular review.
Hepatic cyst puncture sclerotherapy
Principle: destroying the endothelium of cysts by injecting vascular sclerosing agent (commonly used anhydrous ethanol) into the cystic cavity. After pumping the fluid and injecting the drug, the cystic cavity can be gradually reduced, which can receive better immediate results.
Methods: including intracapsular injection of alcohol retention method, puncture placement of alcohol flushing method.
Indications
Mainly for single or multiple cysts with a diameter of >5 cm.
Polycystic livers such as those in which one or several larger cysts are present and cause compression symptoms.
Cysts that are deep and difficult to open or expose surgically.
Those who cannot tolerate surgery.
Contraindications
Alcohol allergy.
Those with severe bleeding tendencies or coagulation disorders.
Those without a safe puncture path.
Those who cannot exclude aneurysm or cystic lesion of hemangioma.
Those with cysts communicating with the biliary tract, renal pelvis, or pancreatic duct.
Precautions
Complications such as pain and infection can sometimes occur, and medical advice is required as to whether or not to choose this treatment.
For polycystic liver disease, single puncture sclerotherapy has limited effect and is prone to recurrence, often requiring repeated multiple puncture sclerotherapy.
Medications
All medications used for treatment need to be used according to your doctor’s orders.
Simple cysts
There is no medication for this type of cyst.
Polycystic Liver Disease
These cysts are rarely treated with drugs as a routine treatment and the following drugs have been reported to be used.
Growth inhibitor analogs
Can inhibit the increase in cyst size.
Commonly used drugs: Octreotide, Paritide, Lanreotide, etc.
Ursodeoxycholic acid (UDCA)
UDCA is an endogenous hydrophilic bile acid, which when taken orally promotes cholestasis, which in turn reduces the concentration of bile in the liver, and also inhibits bile duct proliferation.
mTOR inhibitors
Effects: Immunosuppressive effect by acting on the signaling system downstream of IL-2R, causing the cell cycle to stay in the G1 and S phases.
Commonly used drugs: sirolimus (also known as rapamycin) and everolimus, etc.
Hepatic echinococcosis
Medication is an essential adjunct to surgical treatment. It is often difficult to achieve a cure without surgical treatment.
Commonly used drugs are albendazole and mebendazole.
Albendazole tablets are recognized as effective drugs of choice, long-term application can inhibit the development of lesions, but may prolong the course of the disease.
It should be used in a standardized and reasonable way according to the doctor’s prescription; timely follow-up of blood routine and liver and kidney function.
Chinese medicine treatment
There is no evidence-based medical evidence to support the Chinese medicine treatment of this disease, but some Chinese medicine treatments or medicines can relieve the symptoms, and it is recommended to go to a regular medical institution and be treated under the guidance of a Chinese medicine practitioner.
Prognosis
Cure
Liver cysts develop slowly, and those with small, asymptomatic cysts usually do not need treatment, and regular follow-up is sufficient.
Single liver cysts can be cured by surgery.
Multi-cystic liver can be relieved after treatment, which is helpful for the recovery of liver function and the improvement of general condition.
Hazards
Some liver cysts may cause complications such as jaundice, ascites, rupture of cysts and intracystic hemorrhage.
If combined with polycystic kidney, it may lead to death due to liver and kidney failure.
Daily
Daily Management
Dietary management
Have three regular meals, eat less and more frequently, strictly prohibit overeating and drinking, and maintain an appropriate body weight.
Do not eat high salt and high fat food, such as fatty meat, fried, barbecued and salted food.
Prioritize low-fat foods, such as low-fat milk or yogurt (1 to 2 cups a day), beans, egg whites (no more than 3 whole eggs a week), skinless chicken or fish and shrimp (a poker box size a day), and consume animal liver (about 2 taels of raw weight) once a week.
Replace animal oils with vegetable oils such as peanut, olive, corn and soybean oils.
Don’t limit your staple food to refined white rice and noodles, and alternate variations of all types of coarse grains, mixed beans and potatoes.
Eat less high-sugar foods, such as sugar, candy, sweet drinks, pastries, fruit juice concentrate, jam, honey, etc.
Eat more vegetables (about 500 grams per day), especially green leafy vegetables; eat about 1 fist-sized fruit per day.
Abstain from alcohol to prevent further damage to the liver.
Strictly prohibit intake of moldy food, substandard drinking water, etc.
Exercise management
You can choose low-intensity exercise such as walking, tai chi, etc., which should not be too long and do not cause fatigue.
Work and rest management
Take rest to avoid overwork or fatigue, which may aggravate liver damage.
Maintain a regular routine.
Others
Follow your doctor’s instructions for medication. As liver function is impaired, the metabolism of medication needs to pass through the liver, so do not take other medications or change the dosage of medication on your own.
Maintain a good mood.
Regular medical checkups: Generally speaking, once a year is appropriate for healthy adults, and those with chronic diseases can have the relevant indicators checked according to the doctor’s instructions.
Disease monitoring
Although liver cysts are generally slow to develop, it is necessary to closely monitor the changes in the body in daily life, and should consult the doctor in time if abdominal pain or bloating occurs.
Follow-up examination
Liver cysts may be asymptomatic when they are small and generally do not require treatment, but you should follow up with your doctor regularly to keep an eye on the changes of the cysts.
Prevention
Pay attention to dietary hygiene
Wash your hands before and after meals.
Avoid drinking water of unknown hygiene.
Do not eat food that is not hygienic or cooked properly. For foods that may be susceptible to pathogens, such as pork, pig offal, venison, shellfish, etc., be sure to cook and steam them thoroughly when consuming them, and eliminate bad eating habits such as eating them raw, semi-raw, or directly after pickling.
Adopt good living habits
Quit smoking and limit alcohol.
Take medication as prescribed by the doctor, and do not increase or decrease the dosage on your own.