Assessment of Treatment With Laparoscopic Fenestration or Aspiration Sclerotherapy for Large Symptomatic Hepatic Cysts

Inclusion Criteria: * Age ≥18 years * Hepatic cyst characteristics: * Large (\>5 cm), * Symptomatic (PLD-Q score ≥20), * Non-parasitic on imaging (US/CT/MRI) * Non-neoplastic on imaging (US/CT/MRI) * Providing informed consent Exclusion Criteria: * Clinical indication of a complicated hepatic cyst (cyst rupture or active cyst infection) * Cyst is not laparoscopically accessible for surgery * Cyst is not percutaneously (ultrasound-guided) accessible for aspiration * More than 20 cysts of \>1.5 cm * Age above 75 years * ASA IV * ECOG score \>1 * Aspiration sclerotherapy or laparoscopic fenestration of hepatic cysts was performed in the last 6 months. * Severe renal impairment (eGFR \< 30 ml/min/1,73 m2) * Coagulopathy (spontaneous INR \>2 or platelet count \< 80 x 109/l) * Radiologic contrast allergy * Pregnancy * Any current or prior medical condition that may interfere with the conduct of the study or the evaluation of its results in the opinion of the investigator (e.g. inability to fill out questionnaires).