From the Research
Ascites after resection of large right-sided liver cysts is primarily caused by disruption of lymphatic drainage and portal venous hemodynamics, leading to lymphatic fluid accumulation in the peritoneal cavity, as supported by the most recent study 1 in 2017. The pathophysiology involves the sudden decompression of the liver and portal system after cyst removal, altering pressure gradients and causing increased flow through the liver's lymphatic vessels, which can lead to lymph leakage and fluid accumulation. Key factors contributing to this condition include:
- Disruption of lymphatic drainage
- Portal venous hemodynamics alterations
- Direct damage to lymphatic vessels during resection
- Temporary increase in resistance to portal blood flow due to altered liver architecture Management of post-hepatic cyst resection ascites typically involves:
- Sodium restriction
- Diuretics, such as spironolactone 100-400 mg/day with or without furosemide 40-160 mg/day
- Therapeutic paracentesis in severe cases Most cases of post-hepatic cyst resection ascites are self-limiting and resolve within weeks to months as the liver adapts to its new anatomical configuration, as noted in the study 1. It is essential to consider the patient's overall condition, including liver function and potential complications, when managing ascites, as highlighted in the study 2 from 2018, which discusses the management of ascites and hepatorenal syndrome.