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LIVER CYSTS

UNDERSTANDING THE PROBLEM

The liver is a large organ that sits on the right side of the belly. The liver has two large sections, called the right and the left lobes. The gallbladder sits under the liver, along with parts of the pancreas and intestines. The liver and these organs work together to digest, absorb, and process food. The liver's main job is to filter the blood coming from the digestive tract, before passing it to the rest of the body. The liver also detoxifies chemicals and metabolizes drugs. As it does so, the liver secretes bile that ends up back in the intestines. The liver also makes proteins important for blood clotting and other functions.

Liver cysts (also called hepatic cysts) are fluid-filled sacs that occur in the liver of roughly 5% of the population. They are usually asymptomatic and often discovered by chance during an abdominal imaging procedure, like computed tomography (CT) or magnetic resonance imaging (MRI). Even though most liver cysts are benign, an early diagnosis is critical for proper treatment of the parasitic or cancerous subtypes.

Hepatic cysts usually refers to solitary nonparasitic cysts of the liver, also known as simple cysts. However, several other cystic lesions must be distinguished from true simple cysts. Cystic lesions of the liver include the following:

  • Simple cysts
  • Multiple cysts arising in the setting of polycystic liver disease (PCLD)
  • Parasitic or hydatid (echinococcal) cysts
  • Cystic tumors
  • Abscesses
UNDERSTANDING WHO SUFFERS
  • Simple cysts are present from birth and are formed by abnormal bile duct cells during the embryo’s development. Cysts contain a bile-like fluid and are covered with a thin layer of epithelial cells. They are the most common type of liver cyst and generally measure less than 3 cm in diameter.
  • Echinococcosis is an infection by a species of tapeworm that is transmissible between animals and humans. Specifically, the larval stage of the Echinococcus granulosus (E. granulosus) and Echinococcus multilocularis (E. multilocularis) species produces liver cysts in humans.
  • Cystadenoma and cystadenocarcinoma represent benign and cancerous cystic tumors, respectively. Cystadenomas are similar to simple cysts in that they are of epithelial origin and present from birth. The mechanism by which the cystic tumors become cancerous is not known. Cystadenocarcinomas grow slowly and have a mean diameter of 12 cm.
  • Polycystic liver disease (PLD) is a rare genetic disorder signified by the presence of greater than 20 liver cysts. The cysts are present from birth and cluster together. PLD is closely associated with two other disorders: autosomal dominant polycystic liver disease (PCLD) and autosomal dominant polycystic kidney disease (ADPKD).
POTENTIAL SIGNS AND SYMPTOMS

Liver cysts generally do not affect liver function and may remain asymptomatic for years.

When cysts become enlarged, they can rupture or push against other organs, causing bloating, a feeling of fullness, and a sudden pain in the upper right abdominal region. Sometimes, liver cysts become large enough that can be felt through the abdomen.

Parasitic cysts (echinococcosis) may also cause fever, bloody sputum, and severe skin itching. The type of echinococcosis caused by E. multilocularis (called alveolar echinococcosis) can cause symptoms similar to cirrhosis or liver cancer.

EXAMINATIONS USUALLY REQUIRED

Liver cysts are primarily diagnosed (often by chance) using imaging techniques such as a CT scan, ultrasound, or MRI. A physician may also perform a physical exam of the abdomen to feel for cysts. Cystic echinococcosis is diagnosed using immunodiagnostic tests that detect Echinococcus antibodies in the blood.

PROPOSING TREATMENT AND WHY AIMIS

Surgery for Liver Disorders

If your doctor recommends surgery for a disorder, you may be a candidate for a minimally invasive approach - da Vinci Surgery.

AIMIS is an expert in Robotic Surgery for Robotic Assisted Right & Left Liver Lobectomy, Multiple Liver Segmentectomies, Complex Liver Segmentectomies, Small Resections of the Liver, Wedge non anatomical Resection of the Liver, Segmentectomy of the Liver, Left Lateral Sectionectomy of the Liver, Two Step Liver Resections and other minimal invasive procedures for the Liver involving the best American and International surgeons who are experts in the field including:

  • Hepatic fibrosis and sclerosis - Right & Left Liver Lobectomy, Multiple Liver Segmentectomies, Complex Liver Segmentectomies, Small Resections of the Liver, Wedge non anatomical Resection of the Liver, Segmentectomy of the Liver, Left Lateral Sectionectomy of the Liver, Two Step Liver Resections
  • Central haemorrhagic necrosis of liver - Multiple Liver Segmentectomies, Complex Liver Segmentectomies, Small Resections of the Liver, Wedge non anatomical Resection of the Liver, Segmentectomy of the Liver
  • Infarction of liver - Right & Left Liver Lobectomy, Multiple Liver Segmentectomies, Complex Liver Segmentectomies, Small Resections of the Liver, Wedge non anatomical Resection of the Liver, Segmentectomy of the Liver, Left Lateral Sectionectomy of the Liver, Two Step Liver Resections
  • Hepatic veno-occlusive disease - Right & Left Liver Lobectomy, Multiple Liver Segmentectomies, Complex Liver Segmentectomies, Small Resections of the Liver, Wedge non anatomical Resection of the Liver, Segmentectomy of the Liver, Left Lateral Sectionectomy of the Liver, Two Step Liver Resections
  • Liver Cysts - Right & Left Liver Lobectomy, Multiple Liver Segmentectomies, Complex Liver Segmentectomies, Small Resections of the Liver, Wedge non anatomical Resection of the Liver, Segmentectomy of the Liver, Left Lateral Sectionectomy of the Liver, Two Step Liver Resections
  • Focal nodular hyperplasia of liver - Multiple Liver Segmentectomies, Complex Liver Segmentectomies, Small Resections of the Liver, Wedge non anatomical Resection of the Liver, Segmentectomy of the Liver

Explanation of Surgery Types:

  • Large Liver Resection – Right Lob Removed plus Segmentectomy (segment number 4)
  • Right Liver Lobectomy- Removal of one of the two lobes of liver
  • Left Liver Lobectomy - Removal of one of the two lobes of liver
  • Segmentectomy - Removal of one of the eight segments of liver
  • Multiple Segmentectomies – Two or More removal of the segments of Liver
  • Complex Segmentectomies –Complex removal of the segments of Liver
  • Small Resections – Removal of small parts of Liver ( smaller than Segments)
  • Wedge resection, non-Anatomical - Tumor removal with portion of liver
  • Left Lateral Sectionectomy- Removal of the Left Lateral Segment/section of the Liver
  • Two Step Liver Resection- Liver Regeneration

To see the procedures we undertake with Robotic Xi Surgery, please click here

GETTING MORE INFORMATION BEFORE MOVING FORWARD
YOU MAY HAVE QUESTIONS LIKE:
  • Can I get more information before I commit to this?
  • Can I get a second opinion from you before I commit to this?
  • How can I find out the cost before I have any obligation?
WHAT AIMIS CAN DO:

AIMIS will provide a full review, diagnosis and potential surgical options for your condition, after receiving the relevant examinations and information from you. They will also provide an estimate for your surgical procedure before you decide.

AIMIS’ mission is to the provision of “true” healthcare for those who require it. It provides world leading surgeons using state of the art procedures to optimize potential surgical outcomes, whilst taking care of all arrangements so as to allow concentration on recovery.

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AFFORDABILITY

AIMIS provide competitive prices for state of the art procedures. We also work with a large range of Insurance companies where your policy allows you to have surgery abroad.

 

FURTHER INFORMATION ON THE PROBLEM:

Most liver cysts do not need to be treated. However, if cysts get large and painful, they may need to be drained or surgically removed. Cysts also may be surgically removed if they are stopping bile from reaching the intestine.

If a parasite is found, antibiotics are used for treatment.

Liver cysts can have rare complications of liver failure and liver cancer.

FURTHER INFORMATION ON INCREASED RISK GROUPS

Liver cyst disorders that are congenital (present from birth) or inherited are not preventable. A family history of liver cysts is a good indicator of the likelihood of developing this condition.

Parasitic cysts can be avoided by practicing good hygiene and proper food handling in parts of the world where Echinococcus infections are common, such as Africa, Europe, Asia, the Middle East, and Central and South America. In the United States, such precautions are advisable particularly for those who keep indoor/outdoor pets.

FURTHER EXAMINATION THAT MAYBE REQUIRED OR REQUESTED

Examinations

  • Liver function test (LFT) to measure transaminases or alkaline phosphatase, bilirubin, prothrombin time (PT), and other.
  • In polycystic liver disease (PCLD), LFT , Renal function including blood urea nitrogen (BUN) and creatinine levels
  • In the presence of hydatid cysts, eosinophilia is tested and echinococcal antibody titers
  • For cystic tumors, as with simple cysts, Carbohydrate antigen (CA) 19-9 levels are measured Cyst fluid can be sent for CA 19-9 testing at the time of surgery as a marker for cystadenoma and cystadenocarcinoma.
  • Patients with hepatic abscesses can be evaluated for Leukocytosis.
  • The enzyme immunoassay (EIA) test detects specific antibodies to E histolytica

Imaging

  • In addition to imaging mention earlier in the page: patients who are jaundiced with hydatid disease may undertake a endoscopic retrograde cholangiopancreatography (ERCP) to determine whether the cyst has ruptured into the bile duct.
WHY AIMIS FOR THIS SURGERY

AIMIS is an expert in Robotic Surgery for Robotic Assisted Right & Left Liver Lobectomy, Multiple Liver Segmentectomies, Complex Liver Segmentectomies, Small Resections of the Liver, Wedge non anatomical Resection of the Liver, Segmentectomy of the Liver, Left Lateral Sectionectomy of the Liver, Two Step Liver Resections and other minimal invasive procedures for the Liver involving the best American and International surgeons who are experts in the field

Da Vinci Surgery uses state-of-the-art technology to assist doctors in performing a range of delicate operations for the Liver and offers several potential benefits over traditional open and laparoscopic surgery, including:

  • Low rate of major complications
  • Low conversion rate to open surgery
  • Less scarring
  • High patient satisfaction
  • Minimal pain
  • More precise removal of cancerous tissue
  • Less risk of converting to open surgery
  • Reduced risk of blood loss
  • Shorter hospital stay

The advantage of robotic surgery is the avoidance of large incision, and also helps in removing complex or critical tumors which are otherwise, very hard to do with tradition open surgery methods. As the liver is one of the highly regenerating organ of our body, by employing robotic surgery techniques, one can easily remove complex tumors with minimal discomfort without affecting its regenerating power. Robotic technology has also been successfully used in liver transplantation, which has made liver transplantation simpler with fewer complications.

OTHER SERVICES PROVIDED BY AIMIS

In addition to its Innovative Healthcare, AIMIS provides seamless service along the way. From the start of your journey you'll know the best flights to take, where you'll be staying, what paperwork you will need. You will have a personal assistant assigned; from your pick up at the airport, to your accommodation, continuous assistance at your pre-consultation, through surgery and in your postsurgical care. Our Patients have said that they feel they have become "part of our family" and some even asked to stay a little longer! AIMIS is here to assist you in an all you requirements, allowing you to focus on your health and recovery.

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