Sclerosant Therapy as First-Line Treatment for Solitary Liver Cysts

Abstract

Aim: The aim was to determine the outcome from percutaneous sclerosing treatment of solitary non-parasitic hepatic cysts. Methods: The results of treatment of patients with symptomatic solitary non-parasitic hepatic cysts treated between 1995 and 2000 were reviewed. Results: There were 23 women and one man with a median (range) age of 59 (34–79) years. The median (range) diameter of the cysts was 10 (5–24) cm. Five patients were treated by laparoscopic fenestration ab initio as they also required a cholecystectomy because of gallstones. The remaining 19 patients underwent percutaneous sclerotherapy. In one just aspiration was successful without further treatment. In six contrast leaked from the cyst and five of these had laparoscopic fenestration. Twelve patients had sclerosant treatment with good results at a median (range) follow-up of 35 (6–60) months in 10 patients. Good results were also obtained in 10 of the 12 patients who had fenestration.

Sclerotherapy of simple hepatic cysts by repeated aspiration and alcohol instillation

“…As the trend in the management of hepatic cysts continues to move towards minimally invasive approaches, alcohol sclerotherapy has been advocated as the first-line treatment for SHCs (18). Previous studies have suggested that multiple-session alcohol sclerotherapy can result in low recurrence rates, but it is associated with a higher risk of complications, whereas the single-session procedure is less risky but linked to a high recurrence rate (19).…”

Nine-Year Single-Center Experience with Nonparastic Liver Cysts: Diagnosis and Management

“…Sclerosants used include ethanol [12,19], tetracycline [20], minocycline, and pantopaque [21]. Percutaneous sclerotherapy is usually undertaken as a single-shot procedure.…”

“…The emerging data (Table 3) [12,19,20,[23][24][25][26][27][28][29][30] suggest that sclerotherapy could be a viable alternative to open/laparoscopic deroofing of cysts. However, no randomized controlled trial comparing the two modalities exists to date, and the differing end-points reported by most studies make comparison of the two procedures difficult.…”

“…Symptomatic cysts can be treated by a number of different methods, including percutaneous aspiration and sclerotherapy [12], open deroofing [13], laparoscopic deroofing [14], radical cystectomy or liver resection [13]. In this study, the presentation and management of nonparasitic liver cysts presenting to a single unit over a 9-year period were reviewed.…”

Developmental abnormalities and liver disease in childhood

“…A congenital origin is supported by the occurrence of the cysts in fetuses and newborns, 636 by a case presenting as a congenital diaphragmatic hernia, 644 and the association of another case with the Peutz-Jeghers syndrome. 645 In the past, the treatment of choice of solitary cysts was excision, 646 but this has been supplanted by aspiration and sclerotherapy, 647,648 or laparoscopic fenestration. 649,650…”