Deroofing, fenestration, sclerosing, or marsupialization is done as a temporary fix for pain relief only. Some have had this procedure done laparoscopically. A review of the literature indicates 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 eventually you will need either a liver transplant or a liver resection. Not everyone with liver cysts requires a surgical procedure, only those with severe polycystic liver disease may find it necessary to obtain some type of surgical de-bulking procedure. This is about 8% . The other 92% have few or no symptoms at all from their polycystic liver.