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. 2007 Jun 14;13(22):3095-100.
doi: 10.3748/wjg.v13.i22.3095.

Results of percutaneous sclerotherapy and surgical treatment in patients with symptomatic simple liver cysts and polycystic liver disease

Deha Erdogan  1 , Otto-M van Delden, Erik-Aj Rauws, Olivier-Rc Busch, Johan-S Lameris, Dirk-J Gouma, Thomas-M van Gulik
Affiliations

Results of percutaneous sclerotherapy and surgical treatment in patients with symptomatic simple liver cysts and polycystic liver disease

Deha Erdogan et al. World J Gastroenterol. .

Abstract

Aim: To evaluate the results of the treatment of simple liver cysts (solitary and multiple) and polycystic liver disease (PLD) using percutaneous sclerotherapy and/or surgical procedures in a single tertiary referral centre.

Methods: Retrospective analysis of 54 patients referred for evaluation and possible treatment of simple liver cysts (solitary and multiple) and PLD, from January 1997 to July 2006.

Results: Simple liver cysts were treated in 41 pts (76%) with a mean size of 12.6 cm. The most common reason for referral was abdominal pain or discomfort (85%). Percutaneous sclerotherapy was performed as initial treatment in 30 pts, showing cyst recurrence in 6 pts (20%). Surgical treatment was initially performed in 11 pts with cyst recurrence in 3 pts (27%). PLD was treated in 13 pts (24%) with a mean size of the dominant cyst of 13 cm. Percutaneous sclerotherapy for PLD was performed in 9 pts with recurrence in 7 pts (77.8%). Surgical treatment for PLD was undertaken in 4 pts (30.8%) with recurrence in all. Eventually, 2 pts with PLD in the presence of polycystic kidney disease underwent liver- and kidney transplantation because of deterioration of liver and kidney function.

Conclusion: The majority of patients with simple liver cysts and PLD are referred for progressive abdominal pain. As initial treatment, percutaneous sclerotherapy is appropriate. Surgical deroofing is indicated in case of cyst recurrence after percutaneous sclerotherapy. However, the results of percutaneous sclerotherapy and surgical treatment for PLD are disappointing. Partial liver resection is indicated when there is suspicion of a pre-malignant lesion.

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Figures

Figure 1
Figure 1
Abdominal ultrasound of a solitary simple liver cyst showing a well-defined anechoic unilocular fluid-filled lesion with posterior acoustic enhancement.
Figure 2
Figure 2
Abdominal com-puted tomography of a large solitary simple liver cyst showing a well-demarcated lesion with fluid density and without enhancement after contrast administration.
Figure 3
Figure 3
Abdominal ultrasound of a complicated liver cyst showing a well defined hypoechogenic lesion with solid appearing blood clot contents.
Figure 4
Figure 4
Abdominal computed tomography of a patient with PLD showing multiple cysts throughout the liver.
Figure 5
Figure 5
Proposed algorythm in the management of patients with cystic liver lesions. US indicates ultrasound; CT: computed tomography; PLD: polycystic liver disease.
See this image and copyright information in PMC

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