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Copyright ©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Aug 28, 2008; 14(32): 5066-5072
Published online Aug 28, 2008. doi: 10.3748/wjg.14.5066
Treatment of polycystic liver disease with resection-fenestration and a new classification
Tuan-Jie Li, Hai-Bin Zhang, Jun-Hua Lu, Jun Zhao, Ning Yang, Guang-Shun Yang
Tuan-Jie Li, Hai-Bin Zhang, Jun-Hua Lu, Jun Zhao, Ning Yang, Guang-Shun Yang, Eastern Hepatobiliary Hospital, Second Military Medical University, Shanghai 200438, China
Author contributions: Li TJ and Zhang HB contributed equally to this work; Yang GS and Lu JH designed the study; Zhao J and Yang N performed the study; Li TJ and Zhang HB wrote the paper.
Correspondence to: Dr. Guang-Shun Yang, Eastern Hepato-biliary Hospital, Second Military Medical University, Shanghai 200438, China. gs_yang00@yahoo.com
Telephone: +86-21-25070789 Fax: +86-21-25070789
Received: April 15, 2008
Revised: June 30, 2008
Accepted: July 7, 2008
Published online: August 28, 2008
Abstract

AIM: To evaluate outcomes in patients with autosomal dominant polycyst liver disease (APLD) treated by combined hepatic resection and fenestration. A new classification was recommended to presume postoperative complications and long outcome of patients.

METHODS: Twenty-one patients with APLD were treated by a combined hepatic resection and fenestration technique. All patients were reviewed retrospectively, and clinical symptoms, performance status and morbidity were recorded. A new classification of APLD is recommended here.

RESULTS: All patients were discharged when free of symptoms. The mean follow-up time was 55.7 mo and three patients had a recurrence of symptoms at 81, 68 and 43 mo after operation, respectively. The overall morbidity rate was 76.2%. Two patients with Type B-IIand Type B-I developed biliary leakage. Four patients had severe ascites, including three with Type B-III and one with Type B-II. Nine patients had pleural effusion, including one with Type A-I; one with Type B-I; five with Type B-II; one with Type A-III and one with Type B-III. Three patients with Type B had recurrence of symptoms, while none with Type A had severe complications.

CONCLUSION: Combined hepatic resection and fenestration is an acceptable procedure for treatment of APLD. According to our classification, postoperative complications and long outcome can be predicted before surgery.

Keywords: Autosomal dominant polycyst liver disease; Autosomal dominant polycyst kidney disease; Fenestration