Koea Jonathan B
Department of Surgery, Auckland Hospital, Private Bag 92024, Auckland, New Zealand.
N Z Med J. 2008 Jul 4;121(1277):61-9.
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.
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.
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.
Cystic liver lesions can represent a spectrum of underlying conditions. All cysts require investigation and complex cysts or symptomatic simple cysts require further treatment.
囊肿是肝脏常见的影像学表现。许多患者无需治疗。然而，少数患者因症状或潜在恶性肿瘤风险需要进一步检查和治疗。
2000年建立了奥克兰医院收治的肝脏病变患者的计算机数据库。前瞻性地录入人口统计学、临床表现、检查、治疗及随访的详细信息。
在数据库登记的800多名患者中，确定了47例（36例女性，中位年龄61岁，范围37 - 86岁）需要手术治疗的肝囊肿患者。25例患者表现为单纯性囊肿，其中12例有多囊肝和多囊肾病的影像学证据。所有25例患者均有症状，均通过腹腔镜开窗术成功治疗。9例患者表现为复杂性囊肿，接受了肝切除术。其中，4例为良性囊肿，3例有潜在的胆管囊腺瘤，2例为胆管囊腺癌。1例胆管囊腺癌患者死于疾病。47例患者的中位随访时间为26个月。
肝囊肿可能代表一系列潜在疾病。所有囊肿均需检查，复杂性囊肿或有症状的单纯性囊肿需要进一步治疗。
