Medical and surgical treatment options for polycystic liver disease1

Drenth, Joost P.H.; Chrispijn, Melissa; Nagorney, David M.; Kamath, Patrick S.; Torres, Vicente E.

doi:10.1002/hep.24036

Cited by 205 publications

(229 citation statements)

References 59 publications

Supporting

Mentioning

215

Contrasting

Unclassified

Order By: Relevance

“…Partial liver resection associated with fenestration of the remnant liver has been historically proposed and, although highly successful is some patients, it is associated with high morbidity and mortality rates, and its indications are becoming more selective. Liver transplantation is the only curative modality, and is the only option in patients with anticipated limited efficacy by liver resection [49][50][51] (Figure 1). The appropriate surgical option may be defined based on Gigot's classification; in type Ⅰ, which corresponds only 10% of cases, laparoscopic fenestration is recommended as first option; in type Ⅱ, open fenestration is usually implemented; and type Ⅲ is a contraindication to fenestration and requires resection or liver transplantation in symptomatic cases.…”

Section: Pcldmentioning

confidence: 99%

Current management of noninfectious hepatic cystic lesions: A review of the literature

Macedo¹

2013

WJH

View full text Add to dashboard Cite

Nonparasitic hepatic cysts consist of a heterogeneous group of disorders, which differ in etiology, prevalence, and manifestations. With improving diagnostic techniques, hepatic cysts are becoming more common. Recent advancements in minimally invasive technology created a new Era in the management of hepatic cystic disease. Herein, the most current recommendations for management of noninfectious hepatic cysts are described, thereby discussing differential diagnosis, new therapeutic modalities and outcomes. Key words: simple hepatic cyst; Noninfectious; Polycystic liver disease; Cystadenoma; Cystadenocarcinoma; Caroli's disease; sclerotherapy; Fenestration Core tip: Nonparasitic hepatic cysts consist of a broad spectrum of entities ranging from benign developmental cysts to malignant neoplasms. With recent advancements in diagnostic studies, hepatic cysts are becoming more frequent and better understanding of risk factors, management and long-term outcomes, and further development of current therapeutic modalities are needed.

show abstract

Section: Pcldmentioning

confidence: 99%

Current management of noninfectious hepatic cystic lesions: A review of the literature

Macedo¹

2013

WJH

View full text Add to dashboard Cite

show abstract

“…Documented complications of nonparasitic hepatic cystsinclude obstructive jaundice [9,10] , rupture [11][12][13] , intracystic hemorrhage [13][14][15][16] , and infection [17][18][19] . In PLD, the polycystic liver annually grows by 0.9% to 3.2% [20][21][22][23][24] . As polycystic livers grow up to 10 times their normal size, they compress adjacent abdominal and thoracic organs.…”

Section: Resultsmentioning

confidence: 99%

“…The most commonly reported postoperative complication is ascites, with are latively high incidence of 33% to 69%. Liver transplantation is the only radical treatment option for PLD, but carries high risks of postoperative morbidity and mortality [23,56,64] . Among nonsurgical treatments, a 100% recurrence rate has been reported after cyst aspiration alone; an alternative method of treatment is thus required [65] .…”

Section: Discussionmentioning

confidence: 99%

“…It reflects disease severity and is useful when choosing treatment options. Recently, several reports on PLD treatment have recommended aspiration sclerotherapy, cyst fenestration, and liver resection for Gigot type 1 or 2 PLD and liver transplantation for type 3 PLD; however, no standardized criteria for the selection of treatment exist [5,23,35,46,59,64,65,[73][74][75] . In our series, all patients had Gigot type 2 PLD.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Repeated Minocycline Hydrochloride Injections for Symptomatic Polycystic Liver Disease

Yoshida

Makino

Yokoyama

et al. 2016

Journal of Gastroenterology and Hepatology Research

View full text Add to dashboard Cite

AIM:The present study evaluated the safety and effectiveness of repeated injections of minocycline hydrochloride (MINO) for symptomatic polycystic liver disease (PLD). METHODS:We retrospectively studied patients who received percutaneous MINO injections for symptomatic PLD and were followed up for at least 2 years between 2002 and 2015. Huge hepatic cysts (diameter > 10 cm) were treated by continuous drainage and multiple MINO injections. Small hepatic cysts underwent one-step drainage followed by a single injection of MINO. Only several cysts that caused complications were treated by percutaneous injection of MINO. Patients were discharged 1 day after treatment. RESULTS: Ten patients, (4men and 6 women; mean age, 57.8 years) were studied. All patients had Type 2 PLD according to Gigot's classification. The chief complaints were abdominal distension (n = 10), abdominal pain (n = 6), back pain (n = 4), and appetite loss (n = 8). Four patients had mild liver dysfunction. One patient complained of moderate right subscapular pain immediately after the injection, and another had pain at the site of catheter insertion. Liver dysfunction did not develop in any patient after treatment. The mean follow-up was 63.4 months. The interval from the first to last admission for MINO injection therapy was 14 to 148 months (mean, 40.8 months). The number of admissions for MINO injection therapy ranged from 2 to 12 times (mean, 4.0 times). The average interval for MINO injection therapy was 8.3 to 19 months (mean, 14.8 months).The hepatic cysts shrank in all patients after treatment. Complications improved consistently, and all patients were satisfied with the outcome of treatment. CONCLUSIONS: Symptomatic PLD was controllable by 14.8 months of repeated MINO injections on average. Repeated MINO injections are a safe, definitive treatment for symptomatic PLD.

show abstract

“…These include abdominal discomfort, distension, early satiety and vomiting with associated malnutrition. 8 The symptoms are reported to be more common in women. 9 In addition, there is a significant impact on quality of life (QoL).…”

mentioning

confidence: 99%

Medical therapy for polycystic liver disease

Khan

Dennison

Garcea

2016

annals

View full text Add to dashboard Cite

Introduction Somatostatin analogues and rapamycin inhibitors are two classes of drugs available for the management of polycystic liver disease but their overall impact is not clearly established. This article systematically reviews the literature on the medical management of polycystic liver disease. The outcomes assessed include reduction in liver volume and the impact on quality of life. Methods The English language literature published between 1966 and August 2014 was reviewed from a MEDLINE®, PubMed, Embase™ and Cochrane Library search. Search terms included ‘polycystic’, ‘liver’, ‘sirolimus’, ‘everolimus’, ‘PCLD’, ‘somatostatin’, ‘octreotide’, ‘lanreotide’ and ‘rapamycin’. Both randomised trials and controlled studies were included. References of the articles retrieved were also searched to identify any further eligible publications. The studies included were appraised using the Jadad score. Results Seven studies were included in the final review. Five studies, of which three were randomised trials, investigated the role of somatostatin analogues and the results showed a mean reduction in liver volume ranging from 2.9% at six months to 4.95 ±6.77% at one year. Only one randomised study examined the influence of rapamycin inhibitors. This trial compared dual therapy with everolimus and octreotide versus octreotide monotherapy. Liver volume reduced by 3.5% and 3.8% in the control and intervention groups respectively but no statistical difference was found between the two groups (p=0.73). Two randomised trials investigating somatostatin analogues assessed quality of life using SF-36®. Only one subdomain score improved in one of the trials while two subdomain scores improved in the other with somatostatin analogue therapy. Conclusions Somatostatin analogues significantly reduce liver volumes after six months of therapy but have only a modest improvement on quality of life. Rapamycin inhibitors do not confer any additional advantage.

show abstract

Medical and surgical treatment options for polycystic liver disease1

Cited by 205 publications

References 59 publications

Current management of noninfectious hepatic cystic lesions: A review of the literature

Current management of noninfectious hepatic cystic lesions: A review of the literature

Repeated Minocycline Hydrochloride Injections for Symptomatic Polycystic Liver Disease

Medical therapy for polycystic liver disease

Contact Info

Product

Resources

About