Published in:
01-05-2014 | Hepatobiliary-Pancreas
Hepatic cysts treated with percutaneous ethanol sclerotherapy: time to extend the indications to haemorrhagic cysts and polycystic liver disease
Published in: European Radiology | Issue 5/2014
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Objectives
To describe the long-term clinical and morphological outcome of symptomatic hepatic cysts treated with percutaneous ethanol sclerotherapy (PES).
Methods
From December 2003 to September 2011, all patients with hepatic cysts undergoing PES with a follow-up after 12 months were included. Evolution of the volume of the cysts and clinical and biological data were recorded. Features of the cyst were evaluated in each patient: simple, haemorrhagic or developed on underlying polycystic liver disease (PCLD).
Results
Fifty-eight cysts (median volume 666 mL) were treated in 57 patients (52 women, mean age 58 years (18–80)). Twenty-two patients (39 %) had simple hepatic cysts, 19 (33 %) had dominant cysts on PCLD and 20 had haemorrhagic cysts (34.5 %), including 4 with PCLD. After a mean 27.3 months of follow-up, the final median cystic volume was 13.5 mL (p < 0.0001), and the median reduction in cyst volume was 94 % (58–100 %). Treatment was satisfactory in 95 % of the patients (54/57) (symptoms disappeared in 45/57 (79 %), decreased in 9/57 (16 %)). There was no clinical or morphological difference between patients with PCLD, haemorrhagic cysts or simple cysts.
Conclusion
The clinical and morphological efficacy of a single session of PES is very high, regardless of the presence of intracystic haemorrhage or underlying PCLD.
Key Points
• The clinical efficacy of percutaneous ethanol sclerotherapy is very high.
• Haemorrhagic content should not be a contraindication for percutaneous sclerotherapy.
• Dominant cysts on polycystic liver disease should be treated with PES.
• Imaging follow-up should not be performed shortly after the procedure.