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Liver Cyst Treatment In Singapore

Dr Thng Yongxian

Hepatopancreatobiliary & General Surgeon
MBBS • MMed • MRCS (IRE) • FRCSED • FAMS

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Liver cysts are fluid-filled sacs located within the liver, the largest internal organ of the body. These formations are typically benign and asymptomatic, meaning they often do not cause any symptoms. They can vary greatly in size, ranging from a few millimetres to several centimetres in diameter.

 

The presence of liver cysts is usually detected incidentally during imaging tests for other reasons. While most liver cysts do not affect liver function or health significantly, understanding their characteristics and potential health implications is important for proper management and treatment.

Types of Liver Cysts

Liver cysts encompass a spectrum of conditions that manifest within the liver, varying widely in their aetiology, presentation, and clinical significance.
  • Simple Cysts
    Simple liver cysts are the most common type, typically benign and without symptoms. They are usually discovered incidentally during imaging tests for other conditions.
  • Polycystic Liver Disease (PLD)
    PLD is a genetic condition characterised by the presence of numerous cysts throughout the liver, which can lead to liver enlargement and, in some cases, impair liver function.
  • Hydatid Cysts
    Caused by infection with the Echinococcus tapeworm, hydatid cysts are less common and can pose serious health risks if they rupture, leading to potentially life-threatening complications.
  • Cystadenomas
    These are rare, potentially cancerous cysts that can grow large and may require surgical removal to prevent malignancy.

Causes of Liver Cysts

Congenital Factors

Many liver cysts are congenital, meaning they are present from birth. These cysts may develop due to genetic factors or abnormalities in bile duct formation.

Infections

Certain infections, particularly those caused by parasites like Echinococcus tapeworms, can lead to the development of hydatid cysts in the liver.

Polycystic Liver Disease (PLD)

PLD is a genetic condition where multiple cysts form in the liver, often related to polycystic kidney disease, indicating a hereditary predisposition.

Biliary Duct Obstruction

Blockages or abnormalities in the bile ducts can lead to cyst formation as a result of fluid accumulation.

Liver Injuries

Trauma or injuries to the liver can sometimes result in cyst development as part of the healing process.

Liver Cyst Symptoms

You may experience the following if you have liver cancer. If your symptoms are persistent or worsen, consult a qualified specialist for an accurate diagnosis & prompt treatment.
  • Abdominal Discomfort
  • Nausea
  • Bloating and feelings of fullness
  • Pain in the upper right abdomen
  • Jaundice (yellowing of the skin and eyes), in rare cases where cysts obstruct bile ducts

Liver Cyst Diagnosis

Diagnosis of liver cysts typically involves imaging techniques such as ultrasound, computed tomography (CT) scans, or magnetic resonance imaging (MRI) to visualize the cysts’ size, location, and characteristics. Blood tests may be conducted to assess liver function and rule out infection or malignancy. In certain cases, a biopsy may be performed to definitively diagnose the nature of the cyst.

Imaging Studies

Your doctor may recommend an ultrasound for the initial imaging test, or a CT scan or MRI for a more detailed assessment of the cyst’s features.

Laboratory Tests

Blood tests, including Liver Function Tests (LFTs), can assess your overall liver health. If a parasitic infection (like a hydatid liver cyst) is suspected, specific blood tests (serology) may be ordered.

Differential Diagnosis

It's important to distinguish a simple liver cyst from other conditions, such as parasitic cysts, abscesses, or potentially cancerous cystic tumours.

Get an Accurate Diagnosis & Specialised Treatment For Liver Cyst

If you have been diagnosed with a liver cyst or are experiencing symptoms, consult our dual fellowship-trained surgeon in Singapore today to discuss assessment for potential liver cystic tumour treatment.

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Liver Cyst Treatment Options

The treatment for liver cysts depends on the symptoms and potential complications they may cause. Most asymptomatic cysts require no treatment, but monitoring for changes in size or symptoms is recommended.

  • Observation
    Regular monitoring through imaging tests for asymptomatic or small cysts.
  • Medication
  • Antibiotics for infected cysts
  • Parasiticidal drugs for hydatid cysts caused by Echinococcus tapeworm
  • Percutaneous Aspiration
    For cysts that cause discomfort or symptoms due to their size, percutaneous aspiration under ultrasound or CT guidance may be performed.

    This minimally invasive procedure involves draining the cyst fluid with a needle. To reduce the risk of recurrence, a closing agent may be injected into the cyst cavity to harden it.
  • Laparoscopic Fenestration
    Laparoscopic fenestration is a surgical option for larger or symptomatic cysts not suitable for aspiration or when recurrence occurs.

    This minimally invasive surgery involves creating openings in the cyst wall to allow fluid to drain into the abdominal cavity, where it can be absorbed. The advantages include reduced recovery time and minimal scarring.
  • Liver Resection
    In rare cases where cysts are suspected to be neoplastic or have turned into cancerous growths, a partial liver resection may be necessary.

    This involves the surgical removal of the cyst along with a portion of the liver tissue. Liver resection requires a thorough evaluation of the liver function and the patient’s overall health to ensure a successful outcome.
  • Management of Polycystic Liver Disease (PLD)
    For patients with PLD, where numerous cysts proliferate throughout the liver, management focuses on symptom relief and preventing complications.

    Treatment options may include lifestyle modifications, medications to reduce cyst growth, and, in severe cases, liver transplantation.

Potential Complications

While liver cysts are generally benign, certain situations can lead to complications:

  • Cyst Rupture
    A ruptured cyst can cause severe pain and lead to internal bleeding or infection.
  • Bile Duct Obstruction
    Large cysts may obstruct bile ducts, causing jaundice, cholangitis (infection of the bile ducts), and liver dysfunction.
  • Malignant Transformation
    Although rare, some types of cysts, such as cystadenomas, have the potential to become cancerous.
  • Infection of Cysts
    Cysts can become infected, leading to fever, increased pain, and a risk of spreading the infection.
  • Pressure on Other Organs
    Large or numerous cysts can exert pressure on adjacent organs, causing pain, discomfort, and potential impairment of organ function.

Dr Thng Yongxian

Senior Consultant

HEPATOPANCREATOBILIARY & GENERAL SURGEON

MBBS (SG) • MMed (Surg) • MRCS (Ire) • FRCSEd (Gen) • FAMS (Surg)

Dr Thng Yongxian is a dual fellowship-trained Hepatopancreatobiliary & General Surgeon who has performed over 6000 surgical procedures.

  • Bachelor of Medicine & Bachelor of Surgery
  • National University of Singapore
  • Membership of the Royal College of Surgeons, Ireland
  • Master of Medicine, General Surgery, Singapore
  • Fellow of the Royal College of Surgeons, Edinburgh
  • Fellow of the Academy of Medicine, Singapore

He pursued his subspecialty training in Hepatopancreatobiliary surgery first in the Department of Hepatopancreatobiliary Surgery, Singapore General Hospital. Following this, he completed a clinical fellowship in Minimally Invasive Hepatopancreatobiliary Surgery at Seoul National University Hospital in Bundang, South Korea.


Dr Thng set up and pioneered the Minimally invasive surgery program for his hospital in complex liver and pancreas cases. His surgeries were featured on live national television. His surgical videos have also been presented at international surgical conferences. He also pioneered the use of capsule colonoscopy for colorectal screening.


Dr Thng has served on various committees at hospital, cluster and ministry level. Dr Thng served as a member of the Ministry of Health (MOH) Laparoscopic cholecystectomy Clinician workgroup for value-driven care (VDC).

Prevention and Management

Preventing liver cysts, particularly those of congenital or genetic origin, may not always be possible. However, certain measures can be taken to reduce the risk of developing cysts related to infections or other preventable causes.

Healthy Lifestyle

Maintain a healthy diet and exercise regularly to support overall liver health.

Parasite Prevention

Practice good hygiene, such as washing hands thoroughly and ensuring safe food and water consumption, especially in areas where parasitic infections are common.

Regular Medical Checkups

Routine health screenings can help detect liver abnormalities early, even if symptoms are not present.

Frequently Asked Questions About Liver Cyst Treatment in Singapore

What causes liver cysts to form?
Most simple liver cysts are thought to be congenital, meaning they form before birth due to developmental abnormalities. Other causes include Polycystic Liver Disease (a genetic condition), infections (like hydatid disease from parasites), or, rarely, liver injuries. Often, the exact cause for a simple liver cyst isn’t found.

The vast majority of liver cysts are benign (non-cancerous) and do not turn into cancer. However, rare types, such as cystadenomas, can have the potential to become malignant.

 

It is important for a doctor to properly diagnose the type of cyst, often through imaging, to rule out a cystic tumour and determine if tumour treatment is necessary.

Most liver cysts are harmless. However, you should consult a doctor or surgeon if you experience symptoms like persistent upper abdominal pain, bloating, or jaundice, or if a liver cyst is very large.

 

If imaging tests show complex features (thick walls, internal divisions, or solid areas), further investigation, possibly including liver cystic tumour treatment assessment, is warranted.

Simple liver cysts usually occur as single or a few fluid-filled sacs and typically don’t cause symptoms or affect liver function. Polycystic Liver Disease (PLD) is a genetic disorder characterised by the growth of numerous (often hundreds of) cysts throughout the liver, which can lead to liver enlargement and, in some cases, symptoms or complications requiring treatment.

While rare, liver cysts can sometimes rupture or burst. This risk is higher with very large cysts or specific types like hydatid cysts. A rupture may potentially cause sudden, severe abdominal pain and may lead to infection or bleeding, requiring urgent medical attention and liver treatment in Singapore.

Recurrence depends on the type of liver cyst and the surgery performed. 

Simple aspiration often leads to recurrence. Aspiration with sclerotherapy or surgical fenestration/deroofing by a surgeon has a much lower chance of recurrence. Resection (removal) reportedly offers the lowest risk. 

In PLD, new cysts can still form. Your surgeon can discuss the likelihood based on your specific case.

Recovery time varies with the treatment method. Percutaneous aspiration is usually an outpatient procedure with minimal downtime. Laparoscopic surgery typically involves a hospital stay of a few days and a recovery period of a few weeks. Open surgery, which is less common for simple cysts, requires a longer hospital stay and recovery. Your surgeon in Singapore will provide specific post-procedure guidance.

Related Liver Treatments

Liver Cancer

Liver cancer treatment options in Singapore depend heavily on the stage and liver health, potentially including surgery (resection or transplant), ablation, embolization (TACE/TARE), and systemic therapies. Early consultation with a doctor or surgeon can help determine the most appropriate tumour treatment plan.

LEARN MORE

Liver Cirrhosis

Liver cirrhosis requires management focused on its underlying cause and complications. Treatment involves stopping alcohol intake, managing viral hepatitis (B or C), maintaining a healthy diet, and addressing issues like fluid retention or bleeding.

LEARN MORE

Hepatitis B & C

Hepatitis B and C are viral infections that can lead to chronic liver disease, cirrhosis, and liver cancer. While Hepatitis C can often be cured, Hepatitis B treatment will focus on controlling the virus.

LEARN MORE

Jaundice

Jaundice (yellowing skin/eyes) is a symptom of an underlying issue, not a disease itself. After a diagnosis, treatment can involve managing liver inflammation (like hepatitis), removing gallstones, or addressing bile duct blockages.

LEARN MORE

Corporate & Personal Insurance Plans

Clinic Locations

Nexus Surgical @ Mt. Alvernia

Nexus Surgical @ Mt. Elizabeth Orchard

Nexus Surgical @ Mt. Elizabeth Novena

Nexus Surgical @ Parkway East

Nexus Surgical @ Gleneagles Medical Centre

Nexus Surgical @ Mt. Alvernia

Nexus Surgical @ Mt. Elizabeth Orchard

Nexus Surgical @ Mt. Elizabeth Novena

Nexus Surgical @ Parkway East

Nexus Surgical @ Gleneagles Medical Centre

Nexus Surgical @ Mt. Alvernia

Nexus Surgical @ Mt. Elizabeth Orchard

Nexus Surgical @ Mt. Elizabeth Novena

Nexus Surgical @ Parkway East

Nexus Surgical @ Gleneagles Medical Centre

Need help navigating your health?

If you’re experiencing symptoms or want to understand your treatment options, contact us today.

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Phone: 9838 5827

Email: yongxian.thng@nexussurgical.sg

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