Treatment and its prognosis of polycystic hepatic disease and multiple simple hepatic cysts / 中国综合临床

ABSTRACT

Objective To evaluate the effects of different surgical treatments on polycystic hepatic disease and multiple simple hepatic cysts.Methods A total of 35 cases of polycystic hepatic disease and 54 cases of multiple simple hepatic cysts were surgically treated in our department from Jan.1998 to Jan.2006.Of the 35 cases of polycystic hepatic disease,12 were treated with the partial hepatic resection in combination with cyst fenestration,18 with laparotomic fenestration,5 with laparoscopic fenestration.Of the 54 cases of multiple simple hepatic cysts,6were treated with percutaneons aspiration and instillation of sclerosing agents (ethanol) under the guidance of ultrasonography B,36 with laparotomic fenestration,13 with laparoscopic fenestration.The surgical outcome and longterm follow-up outcome were retrospectively analyzed.Results After treatment,all polycystic hepatic disease patients experienced relief of symptoms when discharged.And the follow-up for an average of 3.0 years showed that 2 patients developed recurrence after the partial hepatic resection in combination with cyst fenestration,8 after the laparotomic fenestration,5 after the laparoscopic fenestration.The recurring rates were 16.7%,44.4% and 100.0% ,respectively.However,all patients of multiple simple liver cysts cured.Conclusions The approach of partial hepatic resection in combination with cyst fenestration is the most effective treatment for polycystic hepatic disease.Liver transplantation can cure polycystic hepatic disease,and is the only effective approach for severe cases.Percutaneous aspiration under the guidance of ultrasonography B is only effective for relief of symptoms before operation.Laparoscopic fenestration should be applied with caution.Laparoscopic fenestration is the first choice for multiple simple hepatic cysts with clinical symptoms.