Complex cyst
Occasionally, the cyst may be classified as complex. In such cases, further investigations may be required to evaluate the risk of it turning cancerous or harbouring a cancer.
Treatment
Simple liver cysts should be treated only when they are symptomatic. Asymptomatic cysts can be left alone as complications arising from such cysts such as infection or bleeding are rare.
The risk of asymptomatic simple cysts getting bigger and eventually causing symptoms is low. Hence there is no need for long-term follow-up of cysts that have been confidently diagnosed as simple liver cysts.
The optimal treatment of symptomatic cyst is to partially remove the wall of the cyst to allow drainage of the cyst into the abdominal cavity. This is now performed mostly through laparoscopic (keyhole) surgery and recovery is fast. The chance of recurrence of cysts treated surgically is low.
Aspiration of the cyst contents, even when combined with alcohol ablation of the cyst wall has high recurrence rate and is generally not recommended.
For complex or high-risk cyst, surgery may be recommended to exclude cancer, removal of the whole cyst with a margin of normal liver may be necessary. These can also be done via minimally-invasive approaches (laparoscopic or robotic), minimising pain and improving recovery.
