Deroofing or sclerosing or marsupilization is done as a temporary fix for pain relief only. A review of the literature shows that this procedure can take as long to perform as some liver resections. Oftentimes deroofing needs repeating. If the doctor has had experience with polycystic liver cysts, he will tell you that eventually you will need either a liver transplant or a liver resection. Not everyone with liver cysts needs a surgical procedure, only those with severe polycystic liver disease will require some type of surgical de-bulking procedure. This is only 8% . The other 92% have few or no symptoms at all from their polycystic liver.