Kystes biliaires

Biliary cysts are frequent hepatic manifestations. They are benign, single or multiple congenital lesions, with a female predominance. In more than half the cases, they remain asymptomatic; fortuitously detected during abdominal investigations, they are observable either by imaging (ultrasonography, CT scanning, MRI), either by surgery (laparoscopy or laparotomy). However, they may evolve and induce various complications: congestive attacks, intracystic hemorrhage, ruptures, infection, compression of the surrounding intra- or extrahepatic tissues. Treatment is indicated only in case of complication or pain. Although laparoscopic resection of the dome is the most frequently used treatment for about twelve years, the recurrence rate remains high. Besides, other therapeutic means exist, such as surgery (cystectomy, hepatic resection, hepatic transplantation) or non-surgical treatments (percutaneous radiological drainage, intracystic injection of sclerotic substances). All these methods have to be carefully discussed before selection, owing to various associated advantages, disadvantages and results.