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Hepatic cysts treated with percutaneous ethanol sclerotherapy: time to extend the indications to haemorrhagic cysts and polycystic liver disease

  • Hepatobiliary-Pancreas
  • Published:
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Abstract

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.

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Abbreviations

ALT:

Alanine aminotransferase

AP:

Alkaline phosphate

AST:

Aspartate aminotransferase

CT:

Computed tomography

GGT:

Gamma-glutamyl transpeptidase

INR:

International normalized ratio

MR:

Magnetic resonance

PCLD:

Polycystic liver disease

PES:

Percutaneous ethanol sclerotherapy

US:

Ultrasound

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Acknowledgements

The scientific guarantor of this publication is Valérie Vilgrain. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. No complex statistical methods were necessary for this paper. Institutional review board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Methodology: retrospective, observational, performed at one institution.

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Authors and Affiliations

  1. Department of Radiology, University Hospitals Paris Nord Val de Seine, Beaujon, Clichy, Hauts-de-Seine, France

    Julie Benzimra, Maxime Ronot, Mohamed Abdel-Rehim, Annie Sibert & Valérie Vilgrain

  2. University Paris Diderot, Sorbonne Paris Cité, Paris, France

    Julie Benzimra, Maxime Ronot, Olivier Farges & Valérie Vilgrain

  3. INSERM U773, Centre de Recherche Biomédicale Bichat-Beaujon, CRB3, Paris, France

    Maxime Ronot & Valérie Vilgrain

  4. Department of Surgery, University Paris Diderot, Sorbonne Paris Cité, University Hospitals Paris Nord Val de Seine, Beaujon, Clichy, Hauts-de-Seine, France

    David Fuks & Olivier Farges

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  1. Julie Benzimra
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Correspondence to Maxime Ronot.

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Benzimra, J., Ronot, M., Fuks, D. et al. Hepatic cysts treated with percutaneous ethanol sclerotherapy: time to extend the indications to haemorrhagic cysts and polycystic liver disease. Eur Radiol 24, 1030–1038 (2014). https://doi.org/10.1007/s00330-014-3117-x

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  • DOI: https://doi.org/10.1007/s00330-014-3117-x

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