Am here to just tell you some basic information regarding Liver cyst.

Basically Cyst is a closed sac with distinct membrane found mostly nearby tissues.

Liver Cyst are fluid filled sacs and are also called as hepatic cyst. 

Usually liver cyst are commonly found in 5% of the population. An American study says that most commonly simple liver cyst are found through Ultrasound LFT i.e radiography, for example find the sample image below:

Cystic lesion of liver includes simple cysts, multiple cysts, arising in the setting of polycystic liver diseases or hydatid cyst. These conditions can usually be distingiuished on the basis of patients symptoms. 
As most of the cyst or abcessess are common just like a stone in kidney but are neglected until the patient gets suffered from it. But dont neglect if you have any symptoms as some cyst can be cured through simple medication or by doing laproscopy or with surgery, it all depends on the CT Scan results. Do consult doctor if you found any symptoms like fever, vomiting, body ache, pain under right abdomen, or sever pain near right shoulder.

Surgery remains the gold standard treatment for hydatid liver disease. The aim of surgical intervention is to inactivate the parasite, to evacuate the cyst along with resection of the germinal layer, to prevent peritoneal spillage of scolices and to obliterate the residual cavity. It can be performed successfully in up to 90% of patients if a cyst does not have a risky localisation. However, surgery may be impractical in patients with multiple cysts localised in several organs and if surgical facilities are inadequate. The introduction of chemotherapy and of the PAIR technique (puncture-aspiration-injection-respiration) offers an alternative treatment, especially in inoperable patients and for cases with a high surgical risk. Cysts with homogeneously calcified cyst walls need, probably, no surgery but only a ‘wait and observe’ approach.

The choice of an optimal treatment should be carefully assessed in each case.

The principles of hydatid surgery are

• Total removal of all infective components of the cysts;
• the avoidance of spillage of cyst contents at time of surgery;
• management of communication between cyst and adjacent structures;
• management of the residual cavity;
• Minimize risks of operation.

All the surgical procedures can be divided into two large groups, a conservative group and a radical one. The conservative technique communication between cyst and adjacent structures;

THE CONSERVATIVE TECHNIQUE

Conservative procedures are safe and technicallysimple, and are useful in the management of uncomplicatedhydatid cysts.Marsupialization was the most common used procedure because it is quick and safe. However, their main disadvantageis the high frequency of postoperative complications,the most common being bile leak from a cyst-biliary communication, bilomas and bile peritonitis (4%-28%).

RADICAL SURGICAL PROCEDURES

Radical surgical procedures include cystectomy, pericystectomy, lobectomy and hepatectomy. Radical procedures have lower rate of complications and recurrences but many authors consider them inappropriate, claiming that intraoperative risks are too high for a benign disease. 

1. Cystectomy –. The procedure involves removal of hydatid cyst, comprising laminar layer, germinal layer and cyst contents (daughter cysts and brood capsules). The procedure is simple to perform and has low recurrence rates.The management of the residual cavity is a challengingproblem especially in patients with gianthydatid Cysts.Various techniques have been described for the management of residual cavities, such as; external drainage,Capitonnage and omentoplasty
2. Pericystectomy – this procedure involves a non-anatomical resection of cyst and surrounding compressed liver tissue. This is technically a more difficult procedure than cystectomy and can be associated with considerable blood loss; it can also be hazardous in the case of large and complicated cysts when the cyst distorts vital anatomical structures such as; hepatic veins or biliary ducts. 
3. Hepatic resections – The arguments against hepatic resection as a primary modality of treatment are :firstly,outside of the dedicated liver units there is considerable morbidity and mortality from resection of what is essentially a benign condition.What is more, the distortion of the anatomy makes surgery harder.

Radical surgery: partial cystectomy 

Drainage of the residual cavity after partial cystectomy 

A34- year- old patient operated for hydatid cyst of segment VIII. Partial cystectomy and capitonnage

Hydatid cyst of liver with portal hypertension: partial cystectomy

Total pericystectomy for a hydatid cyst the lower surface of the right hepatic lobe.

Technique of the pericystectomy 

LAPAROSCOPIC MANAGEMENT OF HYDATID CYSTS

The rapid development of laparoscopic techniques has encouraged surgeons to replicate principles of conventional hydatid surgery using a minimally invasive approach. Several reports have confirmed the feasibility of laparoscopic hepatic hydatid surgery 

A special instrument has been developed for the removal of the hydatid cyst with the laparoscope called the perforator-grinder-aspirator apparatus. Different instruments have been described to try to avoid leackage of daughter cysts and scolices.

Laparoscopic has some advantages compared to open surgery. In fact this approach to liver hydatid cyst offers a lower morbidity outcome and a shorter hospital stay and it is also associated with a faster surgery. In addition to that advantage, Laparoscopic procedure gives a better visual control of the cyst cavity under magnification which allows a better detection of biliary fistula. This approach is possible only in selected cases.

The Criteria to exclude laparoscopic treatment of hydatid cyst of liver are

• Rupture of the cyst in biliary tract
• Central localization of the cyst
• Cysts dimension >15 cm
• Number of cysts > 3
• Thickened or calcified walls
• opening of bile ducts that leak bile

Nevertheless, a disadvantage of laparoscopy is the lack of precautionary measures to prevent spillage under the high intraabdominal pressures caused by pneumoperitoneum, allergic reactions are more common in laparoscopic interventions due to peritoneal spillage, though the length of stay is generally shorter and morbidity rates are lower in comparison with open procedures.

Laparoscopic experience has shown that spillage of scolices-rich cyst fluid or daughter cysts is common, and it is difficult to evacuate the cysts without spillage in the absence of the proven techniques available to open surgery.