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Percutaneous Treatment of Simple Hepatic Cysts: The Long-Term Results of PAIR and Catheterization Techniques as Single-Session Procedures

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Abstract

Purpose

The purpose of our study is to evaluate results of percutaneous aspiration with alcohol sclerotherapy in symptomatic patients with simple hepatic cysts by employing single-session techniques either by a needle or a catheter.

Materials and Methods

We retrospectively included 39 simple hepatic cysts in 35 patients treated via percutaneous aspiration and single-session alcohol sclerotherapy between years 1993 and 2012. Indications were pain (n = 28) or ruling out cystic echinococcus (CE) disease (n = 7). 29 cysts in 26 patients were treated by needle technique (Group A) and ten cysts in nine patients were treated by single-session catheter technique (Group B). Patients were followed for 4–173 months (median: 38 months).

Results

All patients were successfully treated. Before procedure, cyst volumes were 21–676 cc (median: 94 cc). Post-procedure cyst volumes at last follow-up were 0-40 cc (median: 1 cc). The mean decrease in cyst volume was 95.92 ± 2.86 % in all patients (95.96 ± 3.26 % in Group A and 95.80 ± 6.20 % in Group B). There was no statistically significant difference between the volume reduction rates of Group A and Group B. Only one patient, in Group B, developed a major complication, an abscess. Hospitalization period was 1 day for all patients.

Conclusions

For patients with symptomatic simple hepatic cysts smaller than 500 cc in volume by using puncture, aspiration, injection, and reaspiration (PAIR) technique with only needle, single-session alcohol sclerotherapy of 10 min is a safe and effective procedure with high success rate.

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References

  1. Van Sonnenberg E, Wroblicka JT, D’Agostino H, Mathieson JR, Casola G, O’Laoide R, et al. Symptomatic hepatic cysts: percutaneous drainage and sclerosis. Radiology. 1994;90:387–92.

    Article  Google Scholar 

  2. Everson GT, Emmett M, Brown WR, Redmond P, Thickman D. Functional similarities of hepatic cystic and biliary epithelium: studies of fluid constituents and in vivo secretion in response to secretin. Hepatology. 1990;11:557–65.

    Article  CAS  PubMed  Google Scholar 

  3. Larssen TB, Rorvik J, Hoff SR, Horn A, Rosendahl K. The occurence of asymptomatic and symptomatic simple hepatic cysts. A prospective, hospital-based study. Clin Radiol. 2005;60:1026–9.

    Article  CAS  PubMed  Google Scholar 

  4. Roemer CE, Ferrucci JT, Mueller PR, Simeone JF, vanSonnenberg E, Wittenberg J. Hepatic cysts: diagnosis and therapy by sonographic needle aspiration. Am J Roentgenol. 1981;136:1065–70.

    Article  CAS  Google Scholar 

  5. Sanfelippo PM, Beahrs OH, Weiland LH. Cystic diseases of the liver. Ann Surg. 1974;179:922–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Garber S, Mathieson J, Cooperberg PL. Percutaneous sclerosis of hepatic cysts to treat obstructive jaundice in a patient with polycystic liver disease. Am J Roentgenol. 1993;161:77–8.

    Article  CAS  Google Scholar 

  7. Howard RJ, Hanson RF, Delanay JP. Jaundice associated with polycystic liver disease. Arch Surg. 1976;111:816–7.

    Article  CAS  PubMed  Google Scholar 

  8. Terada N, Shimizu T, Imai Y, Kobayashi T, Terashima M, Furukawa K, et al. Benign nonparasitic hepatic cyst causing obstructive jaundice. Intern Med. 1993;32:857–60.

    Article  CAS  PubMed  Google Scholar 

  9. Saini S, Mueller PR, Ferucci JT, Simeone JF, Wittenberg J, Butch RJ. Percutaneous aspiration of hepatic cysts does not provide definitive therapy. Am J Roentgenol. 1983;141:559–60.

    Article  CAS  Google Scholar 

  10. Bean WJ, Rodan BA. Hepatic cysts: treatment with alcohol. Am J Roentgenol. 1985;144:237–41.

    Article  CAS  Google Scholar 

  11. Trinkl W, Sassaris M, Hunter FM. Nonsurgical treatment for symptomatic non-parasitic liver cyst. Am J Gastroenterol. 1985;80:907–11.

    CAS  PubMed  Google Scholar 

  12. Simonetti G, Profili S, Sergiacomi GL, Meloni GB, Orlacchio A. Percutaneous treatment of hepatic cysts by aspiration and sclerotherapy. Cardiovasc Interv Radiol. 1993;16:81–4.

    Article  CAS  Google Scholar 

  13. Larssen TB, Jensen DK, Viste A, Horn A. Single-session alcohol sclerotherapy in benign symptomatic hepatic cysts: long term results. Acta Radiol. 1999;40:636–8.

    Article  CAS  PubMed  Google Scholar 

  14. Larssen TB, Rosendahl K, Horn A, Jensen DK, Rørvik J. Single session alcohol sclerotherapy in symptomatic benign hepatic cysts performed with a time of exposure to alcohol of 10 min: initial results. Eur Radiol. 2003;13:2627–32.

    Article  PubMed  Google Scholar 

  15. Yang CF, Liang HL, Pan HB, Lin JH, Mok KT, Lo GH, et al. Single-session prolonged alcohol-retention sclerotherapy for large hepatic cysts. Am J Roentgenol. 2006;187:940–3.

    Article  Google Scholar 

  16. Erdogan D, Van Delden OM, Rauws EA, Busch OR, Lameris JS, Gouma DJ, et al. Results of percutaneous sclerotherapy and surgical treatment in patients with symptomatic simple liver cysts and polycystic liver disease. World J Gastroenterol. 2007;14:3095–100.

    Google Scholar 

  17. Zerem E, Imamovic G, Omerovic S. Percutaneous treatment of symptomatic non-parasitic benign liver cysts: single-session alcohol sclerotherapy versus prolonged catheter drainage with negative pressure. Eur Radiol. 2007;18:400–6.

    Article  PubMed  Google Scholar 

  18. Kairaluoma MI, Leinonen A, Stahlberg M, Paivansalo M, Kiviniemi H, Siniluoto T. Percutaneous aspiration and alcohol sclerotherapy for symptomatic hepatic cysts. Ann Surg. 1989;210:208–15.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Andersson R, Jeppsson B, Lunderquist A, Bengmark S. Alcohol sclerotherapy of non-parasitic cysts of the liver. Br J Surg. 1989;76:254–5.

    Article  CAS  PubMed  Google Scholar 

  20. Yan-Hong F, Lin-Xue Q, Hai-Ma G, Qing Z, Yu G, Xiangdong H. Sclerotherapy of simple hepatic cysts by repeated aspiration and alcohol instillation. Turk J Gastroenterol. 2012;23:359–65.

    Article  PubMed  Google Scholar 

  21. Benzimra J, Ronot M, Fuks D, Abdel-Rehim M, Sibert A, Farges O, et al. Hepatic cysts treated with percutaneous ethanol sclerotherapy: time to extend the indications to haemorrhagic cysts and polycystic liver disease. Eur Radiol. 2014;24:1030–8.

    Article  PubMed  Google Scholar 

  22. Moorthy K, Mihssin N, Houghton PW. The management of simple hepatic cysts: sclerotherapy or laparoscopic fenestration. Ann R Coll Surg Engl. 2001;83:409–14.

    CAS  PubMed  PubMed Central  Google Scholar 

  23. Gamblin TC, Holloway SE, Heckman JT, Geller DA. Laparoscopic resection of benign hepatic cysts: a new standard. J Am Coll Surg. 2008;207:731–6.

    Article  PubMed  Google Scholar 

  24. Treckmann JW, Paul A, Sgourakis G, Heuer M, Wandelt M, Sotiropoulos GC. Surgical treatment of nonparasitic cysts of the liver: open versus laparoscopic treatment. Am J Surg. 2010;199:776–81.

    Article  PubMed  Google Scholar 

  25. Tocchi A, Mazzoni G, Costa G, Cassini D, Bettelli E, Agostini N, et al. Symptomatic nonparasitic hepatic cysts: options for and results of surgical management. Arch Surg. 2002;137:154–8.

    Article  PubMed  Google Scholar 

  26. Wu S, Li Y, Tian Y, Li M. Single-incision laparoscopic surgery versus standard laparoscopic surgery for unroofing of hepatic cysts. JSLS. 2014;18:246–51.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Garcea G, Rajesh A, Dennison AR. Surgical management of cystic lesions in the liver. ANZ J Surg. 2013;83:E3–20.

    Article  PubMed  Google Scholar 

  28. Loehe F, Globke B, Marnoto R, Bruns CJ, Graeb C, Winter H, et al. Long-term results after surgical treatment of nonparasitic hepatic cysts. Am J Surg. 2010;200:23–31.

    Article  CAS  PubMed  Google Scholar 

  29. Macedo FI. Current management of noninfectious hepatic cystic lesions: a review of the literature. World J Hepatol. 2013;5:462–9.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Karavias DD, Tsamandas AC, Payatakes AH, Solomou E, Salakou S, Felekouras ES, et al. Simple (non-parasitic) liver cysts: clinical presentation and outcome. Hepatogastroenterology. 2000;47:1439–43.

    CAS  PubMed  Google Scholar 

  31. Akinci D, Akhan O, Ozmen M, Gumus B, Ozkan O, Karcaaltincaba M, et al. Long term results of single-session percutaneous drainage and ethanol sclerotherapy in simple renal cysts. Eur J Radiol. 2005;54:298–302.

    Article  PubMed  Google Scholar 

  32. Akhan O, Ozmen MN, Dincer A, Sayek I, Gocmen A. Liver hydatid disease: long term results of percutaneous treatment. Radiology. 1996;198:259–64.

    Article  CAS  PubMed  Google Scholar 

  33. Akhan O, Cekirge S, Ozmen M, Besim A. Percutaneous transcatheter ethanol sclerotherapy of postoperative pelvic lymphoceles. Cardiovasc Interv Radiol. 1992;5:224–7.

    Article  Google Scholar 

  34. Yamamoto K, Sakaguchi H, Anai H, Tanaka T, Morimoto K, Kichikawa K, et al. Sclerotherapy for simple cysts with use of ethanolamine oleate: preliminary experience. Cardiovasc Interv Radiol. 2005;28:751–5.

    Article  Google Scholar 

  35. Goldstein HM, Carlyle DR, Nelson RS. Treatment of symptomatic hepatic cyst by percutaneous instillation of Pantopaque. Am J Roentgenol. 1976;127:850–3.

    Article  CAS  Google Scholar 

  36. Yoshida H, Onda M, Tajiri T, Arima Y, Mamada Y, Taniai N, et al. Long-term results of multiple minocycline hydrochloride injections for the treatment of symptomatic solitary hepatic cyst. J Gastroenterol Hepatol. 2003;18:595–8.

    Article  CAS  PubMed  Google Scholar 

  37. Itou C, Koizumi J, Hashimoto T, Myojin K, Kagawa T, Mine T, et al. Foam sclerotherapy for a symptomatic hepatic cyst: a preliminary report. Cardiovasc Interv Radiol. 2014;37:800–4.

    Article  Google Scholar 

  38. Ben Amor N, Gargouri M, Gharbi HA, Ghorbel A, Golvan YJ, Hammou-Jeddi H, et al. Traitment du kyste hydatique du foie du moton par ponction sous echographie. Tunis Med. 1986;64:325–31.

    CAS  PubMed  Google Scholar 

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Correspondence to Okan Akhan.

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Akhan, O., Islim, F., Balci, S. et al. Percutaneous Treatment of Simple Hepatic Cysts: The Long-Term Results of PAIR and Catheterization Techniques as Single-Session Procedures. Cardiovasc Intervent Radiol 39, 902–908 (2016). https://doi.org/10.1007/s00270-015-1283-0

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  • DOI: https://doi.org/10.1007/s00270-015-1283-0

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