The Basic Anatomy Research About The Wall Of Nonparastic Hepatic Cysts

Hepatic cyst is a common benign liver disease, with the incidence of 1.74%(90/5184)in the abdominal B-ultrasonography. There are two types of hepatic cysts: parasitic hepatic cysts (PHC) and non-parasitic hepatic cysts (NHC) according to different etiopathogenisis. The former one mainly refers to hepatic echinococcosis; while the latter covers inborn and acquired (such as traumatic, inflammatory and tumorous hepatic cysts). Traumatic hepatic cyst is caused by liver hematoma after trauma or pseudo-cysts evolving from liver liquefaction and necrosis. Inflammatory hepatic cyst results from block of calculus of bile duct or the bile duct cyst dilatation due to angusty of bile duct inflammation, also called retention cyst. Tumorous hepatic cysts includes teratoma cyst, cyst lymphoma and cyst adenoid tumor. Among which inborn cyst is the most common one, which covers single and multiple morbidity. It originates in the vagus bile duct or the developmental disorder of intrahepatic bile duct and lymphatic vessel during the embryonic period. The hepatic cyst generally called is congenital cyst of liver. The cyst of different sizes scattered in the liver are called polycystic. It is unusually incorporated with the polycystic kidney, as well as the cysts in the pancreas, spleen, ovary and lung, which is called adult polycystic disease. In recent years, with the development of medical technology, the treatment of hepatic cysts has begun to be diversified. The surgical treatments mainly cover: partial hepatectomy, cystectomy, cyst drainage, open surgery fenestration or laparoscopic fenestration and transplantation of liver; the non-surgical treatments mainly refer to ultrasonic guidance per cutem cyst puncture drainage and inject hardening agent treatment ,and the traditional Chinese medicinal treatment. There may be internal hemorrhage, the infection of cyst caused by the connection with bile duct before the operation of hepatic cyst, while the complication of hemorrhage, the bile leaking, hypoproteinemia may occur after the operation.Purpose: This thesis provides the theoretical basis for the clinical operation dealing with the treatment of hepatic cyst and prevention of hemorrhage of cyst wall, through the comparative study on the basis of cyst wall anatomy of non-parasitic hepatic cyst with complicated and non-complicated hemorrhage, and the study of cyst wall tissue and normal hepatic tissue as well.Methods: 25 cases of hepatic cyst specimens from the patients of hepatic cyst in operation are classified and gathered in our hospital from January 2003 until June 2009. The specimens gathered are preserved in the common paraffin embedding, with six continuous slices and undergo HE colouration respectively. The anatomic structures of the cyst wall are then observed under the microscope of low power and high power. The comparative study is conducted on whether there are differences in the anatomic structures between wall of hepatic cyst with complicated and non-complicated hemorrhage, and that of cyst wall tissue and normal hepatic tissue.Results: there are striking difference in the structures of wall tissue of non-complicated internal hemorrhage cyst and normal hepatic tissue in that the wall of cyst is the irregular fiber tissue; there are complicated blood vessels in the NHC cyst wall under the microscope of the same power with the same vision, and the number of the blood vessels are much more than the normal liver tissue, which is of great significance in statistics (P<0.01). The main differences between the specimens of complicated internal hemorrhage patients in two cases before the operation, one case in operation and one after operation and specimens of non-complicated hemorrhage cyst wall lie in that there is a large amount of destructive blood vessels and red blood cells.Conclusions: 1. The structure of hepatic cyst wall is irregular and there are lots of blood vessels in the cyst wall fibers, particularly in the complicated internal hemorrhage. 2. There are differences on the structure of hepatic cyst wall between the hemorrhage and non-hemorrhage in the complicated cyst, with large amount of destructive blood vessels and red cells in the complicated cyst with internal hemorrhage. 3. The basic research on the anatomy of wall of non-parasitic hepatic cyst lays the theoretical foundation for the significance of exact hemostasis during the surgical operation for hepatic cyst.