A 53-year-old woman presented with increasing right upper quadrant pain. CT scan revealed a large unilocular cyst occupying the dome and posterior part of the right lobe of the liver. Workup revealed no evidence of infectious or parasitic etiology. Attempted sclerosis with hypertonic saline and alcohol were unsuccessful. Cystogram revealed no connection to the biliary system. A diagnosis of giant congenital hepatic cyst was made. Surgical unroofing and obliteration was undertaken to relieve the symptoms.
Because of the high posterior position of the cyst, laparoscopic treatment was not considered feasible. The liver was exposed through a subcostal incision. Falciform ligament and right triangular ligament were divided (see hepatic segmental anatomy) to mobilize the right lobe of the liver.
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