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Abstract: The patient came to the clinic with right upper abdominal distension and pain lasting for 6 months. Liver cysts are common benign tumors of the liver, which usually do not cause clinical symptoms, but are usually detected during physical examination. If the liver cysts continue to grow, they may cause distension and discomfort in the right upper abdomen.
Basic information】Male, 67 years old
Disease Type】Hepatic cyst
Hospital】Liaocheng People’s Hospital
Date of Consultation】November 2021
Treatment plan】Laparoscopic decompression of liver cysts
Treatment Period】4 days of hospitalization and 1 month of follow-up
Effectiveness】Discomfort in the right upper abdomen disappeared and the cyst disappeared
I. Initial consultation
This is an elderly patient who came to the clinic and told me that he had been feeling uncomfortable in his right upper abdomen for 6 months, and at the same time he had lost his appetite and was not eating well, so he came to have a checkup. The preliminary diagnosis was liver cyst, and the patient was advised to undergo surgery. The patient’s body is usually strong and does not have basic diseases such as hypertension, diabetes and heart disease, and his body condition can also tolerate surgery, so the patient was recommended to undergo surgery.
II. Treatment process
After admission, the patient underwent routine examination, the blood routine, liver function and kidney function were all normal, and the tumor markers were also within the normal range, suggesting that the cyst should be a benign cyst. The patient was given an abdominal plain CT, which was able to visualize a cyst of about 10 cm in diameter in the right anterior lobe of the liver, as well as some smaller cysts. These cysts could be treated simultaneously intraoperatively. The patient was also in very good physical condition to tolerate the surgery and the surgery could be a minimally invasive laparoscopic procedure with very little trauma to the patient. The above information was then communicated to the patient’s family, who expressed their agreement with the surgical plan. The patient then underwent laparoscopic decompression of liver cysts under general anesthesia, during which multiple cysts were removed. The postoperative pathology confirmed that the cysts were simple benign cysts and the patient recovered well after surgery.
III. Treatment results
After the precise evaluation of preoperative abdominal CT, multiple cysts were found on the patient’s liver, so not only the largest cyst was treated intraoperatively, but also many smaller cysts were treated, which treated the patient’s liver cysts more thoroughly. Eventually, the patient’s right upper abdominal distension and pain disappeared after surgery. Because the patient underwent laparoscopic surgery, the trauma was very small and the surgical incision was also very small, so the patient got out of bed on the first postoperative day, started to eat on the second postoperative day, and basically resumed normal life and was discharged on the third postoperative day with a length of stay of 4 days.
IV. Notes
We are glad that after the surgery, the patient’s liver cyst was cured, but it is recommended that the patient should pay more attention to rest and avoid straining within 1 week after discharge, and the stitches of the incision should be removed until about 7 days after the surgery, and the stitches should be removed at the local hospital, while gradually increasing the amount of food and nutrition, and the patient can return to normal life and work about 2 weeks after surgery. One month after surgery, you should return to the hospital for a follow-up examination. The review usually includes routine blood tests, liver function and abdominal ultrasound. If no abnormality is found, it is usually necessary to review once every 1 year because in a few patients, liver cysts tend to recur and form larger cysts again, which may require 2 surgeries, so regular review can detect cyst recurrence early and provide early treatment.
V. Personal insight
This patient underwent surgery because the cyst grew relatively large and caused symptoms of distension and pain in the right upper abdomen. Most patients have relatively small and slow growing liver cysts, which usually do not require special treatment and only need regular review. However, in a few patients, liver cysts may grow faster or grow larger and cause clinical symptoms, including right upper abdominal distension and pain or pressure on abdominal organs, etc. In such cases, surgery is required, which is generally performed by minimally invasive laparoscopic surgery. The surgery is mainly performed by decompression of liver cysts, but for some suspected cystic tumors, resection of cysts may be required.