Efficacy and Safety of Aspiration Sclerotherapy of Simple Hepatic Cysts: A Systematic Review

Wijnands, Titus F. M.; Görtjes, Alena P M; Gevers, Tom J.G.; Jenniskens, Sjoerd F.M.; Kool, Leo J Schulze; Potthoff, Andrej; Ronot, Maxime; Drenth, Joost P.H.

doi:10.2214/ajr.16.16130

Cited by 70 publications

(82 citation statements)

References 30 publications

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“…More invasive treatments include aspiration sclerotherapy (AS), liver cyst fenestration, hepatic resection, and LT. AS involves percutaneous cyst fluid aspiration with injection of a sclerosing agent to destroy the epithelial lining and prevent future fluid secretion. AS is a safe and efficacious technique for patients who have one or a few large, dominant cysts with diameters greater than 5 cm . The majority of patients report an improvement (72%‐100%) and complete resolution of symptoms (56%‐100%).…”

Section: Initiate Treatmentmentioning

confidence: 99%

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A Practical Approach to Polycystic Liver Disease

Patel

Chapman

Mikolajczyk

2019

Clinical Liver Disease

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Section: Initiate Treatmentmentioning

confidence: 99%

“…The majority of patients report an improvement (72%‐100%) and complete resolution of symptoms (56%‐100%). Cyst volume reduction ranges from 76% to 100% . A common complication is postprocedural pain from peritoneal irritation.…”

Section: Initiate Treatmentmentioning

confidence: 99%

A Practical Approach to Polycystic Liver Disease

Patel

Chapman

Mikolajczyk

2019

Clinical Liver Disease

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“…Next, a sclerosing agent (eg ethanol, tetracycline, polidocanol) is injected, which damages the inner epithelial lining resulting in regression of the cyst . A recent systematic review found that aspiration sclerotherapy reduces proportional cyst volume by 76%‐100% . Aspiration sclerotherapy comes with complications such as pain, ethanol intoxication, cyst bleeding and rarely cyst infections .…”

Section: Management Of Portal Hypertension In Pldmentioning

confidence: 99%

Management of portal hypertension and ascites in polycystic liver disease

Bernts

Drenth

Tjwa

2019

Liver International

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Patients suffering from polycystic liver disease may develop Hepatic Venous Outflow Obstruction, Portal Vein Obstruction and/or Inferior Caval Vein Syndrome because of cystic mass effect. This can cause portal hypertension, leading to ascites, variceal haemorrhage or splenomegaly. For this review, we evaluate the evidence to provide clinical guidance for physicians faced with this complication. Diagnosis is made with imaging such as ultrasound, computed tomography or magnetic resonance imaging. Therapy includes conventional therapy with diuretics and paracentesis, and medical therapy using somatostatin analogues. Based on disease phenotype various (non‐)surgical liver‐volume reducing therapies, hepatic or portal venous stenting, transjugular intrahepatic portosystemic shunts and liver transplantation may be considered. Because of complicated anatomy, use of high‐risk interventions and lack of empirical evidence, patients should be treated in expert centres.

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“…Other clinical manifestations may include epigastric fullness nausea, breathlessness, infection and intracystic haemorrhage and in more rare cases cardiac compromise . A wide range of interventions is available for the treatment of symptomatic or complicated cysts; these include simple aspiration, liver resection, and transplantation for incapacitating PCLD . Intraperitoneal fenestration by deroofing, the excision of the cyst dome to allow the free drainage of the cystic epithelium into the peritoneal cavity is the most widely used procedure.…”

Section: Introductionmentioning

confidence: 99%

Robotic fenestration of massive liver cysts using EndoWrist technology

Tsirlis

Thakkar

Sen

et al. 2019

Robotics Computer Surgery

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Background We present the short‐term outcomes of robotic fenestration of symptomatic liver cysts using the EndoWrist One Vessel Sealer. Methods Data from patients who underwent robotic deroofing were collected and analysed retrospectively. Results A total of 17 patients were treated. Mean cyst size was 14 cm (median 15 cm, range 6.3‐24). Seven cysts were in posterosuperior or central segments. There were no mortalities or conversions. Blood loss was minimal in all but one case of 200 ml. Mean operating time was 174 minutes (median 170 min, range 97‐335). Mean hospital stay was 2.5 days (median 2 days, range 1‐10). One patient developed a bile leak requiring ERCP. There are no recurrences with a median follow‐up of 19 months. Conclusion Robotic fenestration can be safely performed and offers distinct advantages over the laparoscopic approach in the treatment of posterosuperior and perihilar cysts at the expense of longer operating times and increased cost.

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Efficacy and Safety of Aspiration Sclerotherapy of Simple Hepatic Cysts: A Systematic Review

Abstract: We found excellent results with respect to long-term efficacy and safety after aspiration sclerotherapy of hepatic cysts. Nevertheless, because of the high risk of bias in the included studies, definite conclusions regarding efficacy cannot be drawn.

Cited by 70 publications

References 30 publications

A Practical Approach to Polycystic Liver Disease

A Practical Approach to Polycystic Liver Disease

Management of portal hypertension and ascites in polycystic liver disease

Robotic fenestration of massive liver cysts using EndoWrist technology

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