Single-session alcohol sclerotherapy of symptomatic liver cysts using 10–20 min of ethanol exposure: no recurrence at 2–16 years of follow-up

Abstract

PurposeTo assess long-term results after single-session alcohol sclerotherapy of symptomatic benign liver cysts performed with maximum 20 min of exposure to alcohol.MethodsWe included 47 patients aged 32–88 years (42 women, 5 men) with 51 benign non-parasitic liver cysts that were exposed to ethanol for 7–20 min in a single sclerotherapy session and were followed for at least 24 months. Each cyst was emptied before injecting ethanol (10% of cyst volume, but maximum 100 mL) into it. The patient rotated from side to side to facilitate contact between ethanol and the whole cyst wall. Pre-treatment cyst volume was defined as the volume of aspirated cyst fluid after complete emptying of the cyst. Follow-up cyst volume was estimated based on computed tomography images.ResultsCyst volumes were 30–4900 (median 520) mL at pre-treatment and 0–230 (median 1) mL at 24–193 (median 56) months follow-up, a reduction of 83–100% (median 99.7%). No cyst required repeated treatment during the follow-up. Median volume reduction was 99.7% at median 49 months of follow-up for 35 cysts exposed to ethanol for 7–10 min vs. 99.6% at median 75 months of follow-up for 16 cysts exposed for 20 min (p = 0.83, Mann–Whitney test). Ethanol intoxication occurred in one patient. There were no other complications except for pain.ConclusionLong-term results of single-session alcohol sclerotherapy performed with maximum 20 min of exposure to ethanol were satisfactory with no sign of recurrence of cyst fluid.

Catheter-directed Sclerotherapy for Ovarian Endometrioma: Short-term Outcomes

“…Surgical resection of the endometrioma can adversely affect ovarian reserve because the normal ovarian parenchyma is inevitably resected to a varying degree. Decline in serum AMH level, a ney, and lymphocele, and sclerotherapy has been primarily performed via a drainage catheter (18)(19)(20). In this study, we used CDS, using a pigtail catheter instead of a needle to overcome the technical disadvantages of NDS.…”

Tamoxifen for the treatment of polycystic liver disease

“…The treated cyst had refilled to an estimated 103 mL (original volume 221 mL), which is expected shortly after sclerotherapy. [ 9 ] Remarkably, the other cysts had also decreased in volume without any intervention (Fig. 2 ).…”

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“…The sclerosing agent should sufficiently contact the whole cyst cavity during the treatment procedure, thus leading to correction of the epithelial cells and cessation of their ability to secrete fluid . However, liquid sclerosing agents could mix with the residual fluid in the cyst and reduce their sclerotic effect.…”

“…Percutaneous aspiration without sclerotherapy results in early recurrence of hepatic cysts; therefore, aspiration together with sclerotherapy is essential for effective treatment . Ethanol and minocycline hydrochloride have been conventionally used as sclerosing agents . However, these agents can cause undesired adverse effects (AEs) such as abdominal pain, high fever, and alcoholic intoxication .…”

“…Ethanol and minocycline hydrochloride have been conventionally used as sclerosing agents . However, these agents can cause undesired adverse effects (AEs) such as abdominal pain, high fever, and alcoholic intoxication . In addition, fluid re‐accumulation after sclerotherapy using ethanol or minocycline has been reported .…”