Cystic lesions of the liver: 6 years of surgical management in New Zealand.

Introduction: Cysts are a common radiological finding in the liver. Many affected patients do no require treatment. However a minority require further investigation and treatment for symptoms or risk of underlying malignancy.
Methods: A computerised database of patients presenting to Auckland Hospital for the management of liver lesions was established in 2000. Details of demographics, presentation, investigations, management, and follow-up are entered prospectively.
Results: Forty-seven patients (36 female, median age 61, range 37-86 years) requiring surgical treatment of cystic liver lesions were identified from a total of over 800 patients enrolled in the database. Twenty-five patients presented with simple cysts, of whom 12 had radiological evidence of polycystic liver and kidney disease. All 25 patients were symptomatic and all were managed successfully with laparoscopic fenestration. Nine patients presented with complex cysts which were treated with liver resection. Of these patients, four had benign cysts, three had underlying biliary cystadenomas, and two had biliary cystadenocarcinomas. One patient with a biliary cystadenocarcinoma is dead of disease. The median follow-up for all 47 patients was 26 months.
Conclusions: Cystic liver lesions can represent a spectrum of underlying conditions. All cysts require investigation and complex cysts or symptomatic simple cysts require further treatment.