Repeated Minocycline Hydrochloride Injections for Symptomatic Polycystic Liver Disease

Abstract

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.