Optimizing surgical management of symptomatic solitary XXXX .

@entity1 @entity5 @entity189 @entity158 @entity99 @entity9296
Four @entity1 and six @entity1 with symptomatic solitary @entity99 were encountered over an 11-year period. Average age was 49 years (range, 10 months to 67 years). Most common clinical features included @entity158 , a palpable RUQ mass and early postprandial satiety. Liver function studies were uniformly normal. Ultrasound and computerized tomography CT were virtually diagnostic alone or in combination. Eight @entity1 had unilocular, simple cysts and two @entity1 had multilocular complex cysts also designated as @entity9296 . Cysts recurred in four @entity1 treated surgically by needle aspiration, incision, and internal drainage or external catheter drainage. All four @entity1 required reoperation, which included @entity99 in three @entity1 and extensive unroofing in one @entity1 . No cysts have recurred in six @entity1 treated by extensive unroofing or excision of the cyst and none has required reoperation. One @entity1 who underwent @entity99 for cyst recurrence after an inadequate primary procedure was found to have an unsuspected @entity189 in the cyst wall. The conclusion is that extensive unroofing of unilocular solitary @entity99 minimizes the likelihood of cyst recurrence and obviates the need for hepatic resection. Total cyst excision is indicated for all multiloculated cysts to avoid overlooking a @entity9296 or for unilocular cysts if the biopsy specimen of the cyst wall demonstrates an unsuspected @entity5 .
