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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.
Liver cysts encompass a spectrum of conditions that manifest within the liver, varying widely in their aetiology, presentation, and clinical significance.
Simple liver cysts are the most common type, typically benign and without symptoms. They are usually discovered incidentally during imaging tests for other conditions.
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.
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.
These are rare, potentially cancerous cysts that can grow large and may require surgical removal to prevent malignancy.
Liver cysts often remain asymptomatic and are discovered incidentally during imaging for unrelated issues. However, when symptoms do occur, they may include the following:
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.
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.
Certain infections, particularly those caused by parasites like Echinococcus tapeworms, can lead to the development of hydatid cysts in the liver.
PLD is a genetic condition where multiple cysts form in the liver, often related to polycystic kidney disease, indicating a hereditary predisposition.
Blockages or abnormalities in the bile ducts can lead to cyst formation as a result of fluid accumulation.
Trauma or injuries to the liver can sometimes result in cyst development as part of the healing process.
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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.
Regular monitoring through imaging tests for asymptomatic or small cysts.
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, sclerotherapy may be administered, where a sclerosing agent is injected into the cyst cavity to harden it.
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.
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.
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.
While liver cysts are generally benign, certain situations can lead to complications:
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.
Maintain a healthy diet and exercise regularly to support overall liver health.
Practice good hygiene, such as washing hands thoroughly and ensuring safe food and water consumption, especially in areas where parasitic infections are common.
Routine health screenings can help detect liver abnormalities early, even if symptoms are not present.
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.
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).
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820 Thomson Road, #06-05 ,Singapore 574623
Monday-Friday: 9.00am-5.00pm
(Lunch: 1.00-2.00pm)
Saturday: 9.00am-1.00pm
Sunday & PH: Closed
Yes, liver cysts are relatively common and often discovered incidentally during imaging tests for other conditions. Most cysts are benign and asymptomatic.
There is no direct evidence that lifestyle changes can shrink existing liver cysts. However, maintaining a healthy lifestyle can support overall liver health and potentially prevent the formation of new cysts.
Like any surgical procedure, liver cyst removal carries certain risks, such as infection, bleeding, and complications related to anaesthesia. However, with advances in surgical techniques, especially laparoscopic surgery, the risks are minimized, and recovery times are generally shorter.
Yes, liver cysts can recur after treatment, particularly in cases of polycystic liver disease or if the entire cyst is not removed. Regular follow-up with a healthcare provider is important to monitor for recurrence.