How Liver Cysts Are Treated

About 5% to 10% of the population has liver cysts; however, they are mostly harmless. Around 5% of people with them require treatment that's typically only offered if the cysts are painful, large, affect liver function, or are cancerous.

Liver cyst treatment may include draining the cyst, surgically removing it, taking medications, or having a liver transplant (in extreme cases).

In this article, learn more about liver cysts and their various treatment options.

Surgeries and Specialist-Driven Procedures

Of the small percentage of people requiring treatment for liver cysts, it's usually because the cyst has grown large enough to cause pain in the right upper abdominal area, affects liver function, or blocks bile (a digestive fluid that breaks down fatty acids) from moving into the intestines. When this is the case, draining or surgery may be required.

Draining

Draining a liver cyst, called percutaneous aspiration, is often not a permanent solution. However, it is usually offered first because it is less invasive than surgery.

For the procedure, your healthcare provider will use ultrasound or computed tomography (CT) imaging to visualize the cyst. Then, they will insert a needle into the cyst to drain the fluid, leaving an empty sac. You may be awake for the procedure, but local anesthetics will be administered so you don't feel any pain.

One issue with draining a liver cyst—and the reason it isn't a permanent solution—is that the cyst sac remains, allowing it to refill with fluid. To prevent this, your healthcare provider may use a sclerosing agent (an injection to help fluid from accumulating).

Surgical Removal

Surgery is considered more radical and is usually only tried if draining the cyst is not an option or it has already grown back. The two surgical treatments offered include:

• Laparoscopic de-roofing: The "roof" (top) of the cyst is removed. The surgeon may let the open wound heal by itself or suture (stitch) more tissue over it.
• Complete cyst excision: Also called a hepatectomy, this type of surgery involves cutting the cyst out by its root and completely removing it along with some of the surrounding liver tissue.

Prescriptions

Liver cysts are not generally treated with prescription medications unless the echinococcus parasite causes them. This parasite is found in sheep and dogs but can transfer to humans, called hydatid disease. Medication is often prescribed with surgical removal or drainage of the cyst.

Albendazole

If you have hydatid disease, your healthcare provider may prescribe the antiparasitic medication Albenza (albendazole), pre- and postoperatively. This can reduce the chance of cysts recurring after surgery and may reduce the size of the cyst.

Albendazole and Praziquantel

Combining albendazole and Biltricide (praziquantel) is more effective than albendazole alone and is safe to use with minimal adverse effects.

Over-the-Counter (OTC) Therapies

No OTC (nonprescription) medications or therapies can remove or reduce the size of liver cysts. However, if you are experiencing pain related to liver cysts, your healthcare provider can advise on appropriate analgesics (pain relievers) that can help.

Home Remedies and Lifestyle

One lifestyle factor that may increase your risk of developing parasitic liver cysts is exposure to infected sheep; however, this mainly affects sheep farmers. Unless you have an occupational hazard, you shouldn't be worried about this.

If you have been diagnosed with a liver cyst, your healthcare provider may choose to watch and wait if the cyst is less than 4 centimeters and causes no symptoms. You may keep a diary of any symptoms, such as bloating, pain in the upper right abdomen, and the physical appearance of a bump in that area.

Summary

Most of the time, liver cysts are harmless and don't require treatment. Your healthcare provider may determine appropriate treatments based on the size of your cyst, associated symptoms, and the cause of your cyst (if known to be parasitic).

For around 5% of those who do need treatment, options include drainage, surgical methods of laparoscopic de-roofing, or complete excision if the cyst recurs. Your healthcare provider may prescribe certain antiparasitic medications if the parasite, echinococcus, causes the cyst.

A Word From Verywell

If you have a liver cyst, speak to your healthcare provider about treatment options, recurrence rates, and any side effects or risks associated with each procedure or medication. Help is available if treatment is required.