Percutaneous treatment of symptomatic non-parasitic benign liver cysts: Single-session alcohol sclerotherapy versus prolonged catheter drainage with negative pressure

Abstract

To evaluate whether prolonged catheter drainage with negative pressure yields better results than single-session alcohol sclerotherapy in the treatment of symptomatic non-parasitic benign liver cysts. Forty patients were randomly assigned to two groups in a 24-month prospective controlled trial. One group was treated with ultrasound-guided prolonged catheter drainage with negative pressure (20 patients with 24 cysts) and the other group with single-session alcohol sclerotherapy (20 patients with 23 cysts). Patient demographics, clinical characteristics, treatment outcome, and complications were analyzed. The median volumes and 95% CI (confidence interval) for the medians and interquartile ranges of all 47 cysts before treatment and on last follow-up were: 389 ml, 143-1,127 ml, 136-1,300 ml, and 0 ml, 0-10 ml, and 0-23 ml, respectively (P<0.0001). The average volume reduction was 92.4% (range, 74.9-100%), 94.2 % (range, 74.9-100%) in the drainage and 90.2% (range, 76.9-100%) in the sclerotherapy group. Twenty-seven cysts (57.4%) disappeared completely, 16 (66.7%) in the drainage and 11 (47.8%) in the sclerotherapy group. No differences in average volume reduction, final volume and disappearance of the cysts between the groups were noted. The hospital stay was 1 day for all patients. Percutaneous treatment is safe and effective for hepatic non-parasitic cysts. Prolonged catheter drainage with negative pressure and single-session alcohol sclerotherapy had similar results.

CT-Guided Sclerotherapy With Ethanol Concentration Monitoring for Treatment of Renal Cysts

“…The results were similar to several other studies reported in the international literature [28,29]. In practice, we observed that the aspirated cyst fluid was clear at the beginning, but the aspirated liquid became cloudy after the injection of ethanol.…”

“…There was a significant difference between the success rate of group A (without ethanol concentration monitoring) and group B (with ethanol concentration monitoring). The 100% (21/21) success rate in group B was significantly better compared with other reports [28,29]. There were several factors that might contribute to the high success rate in our group B.…”

Surgical management of cystic lesions in the liver

“…In addition, many centres describe their experience in the management of all cysts and treatments (polycystic and simple, laparoscopic and open). Table 1 summarizes the results following aspiration sclerotherapy of liver cysts 17,20,22,42–53 and Table 2 shows the results following laparoscopic treatment of liver cysts 16,28,30–41,54–59 . While percutaneous sclerotherapy appears to be effective in decreasing cyst size, recurrence rates are higher and data studies reporting experience of both surgical de‐roofing and percutaneous sclerotherapy suggest recurrence rates of 2% versus 75%, respectively 55 .…”

Ultrasound‐guided microfoam sclerotherapy with polidocanol for symptomatic giant hepatic cyst: Initial experience

“…They contain serous fluid and do not communicate with intrahepatic biliary trees. Simple hepatic cysts are present in 2.5–18% of the general population and are asymptomatic in most cases . However, giant cysts occasionally cause various complications such as abdominal distention, pain, nausea, portal hypertension, and obstructive jaundice .…”