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World J Gastroenterol. Jun 14, 2007; 13(22): 3095-3100
Published online Jun 14, 2007. 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, Otto M van Delden, Erik AJ Rauws, Olivier RC Busch, Johan S Lameris, Dirk J Gouma, Thomas M van Gulik
Deha Erdogan, Olivier RC Busch, Dirk J Gouma, Thomas M van Gulik, Department of Surgery, Academic Medical Center, University of Amsterdam, The Netherlands
Otto M van Delden, Johan S Lameris, Department of Radiology, Academic Medical Center, University of Amsterdam, The Netherlands
Erik AJ Rauws, Department of Gastroenterology, Academic Medical Center, University of Amsterdam, The Netherlands
Author contributions: All authors contributed equally to the work.
Correspondence to: TM van Gulik, MD, Department of Surgery, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. t.m.vangulik@amc.uva.nl
Telephone: +31-20-5665570 Fax: +31-20-6976621
Received: March 26, 2007
Revised: April 8, 2007
Accepted: April 16, 2007
Published online: June 14, 2007
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.

Keywords: Simple liver cyst; Polycystic liver disease; Percutaneous sclerotherapy; Deroofing; Complications