Outcomes of mini-invasive ultrasound-guided percutaneous interventions in non-parasitic hepatic cysts and polycystic liver disease

Aim. To evaluate short- and long-term outcomes of percutaneous sclerotherapy in patients with non-parasitic hepatic cysts and polycystic liver disease.

Materials and methods. Between 2016 and 2023, 106 patients with non-parasitic hepatic cysts underwent interventions. Multiple cysts were observed in 38 patients (35%) and polycystic liver disease was diagnosed in 24 patients (23%).

Results. Complications were observed in 10 patients (9%). In six of them, cyst cavity infection occurred, which required repeat drainage (Clavien–Dindo grade IIIA); other complications were managed conservatively (grades I and II). Long-term outcomes were followed up in 98 patients (92%) over a period ranging from 6 months to 8 years. After drainage of solitary and multiple hepatic cysts, no recurrence of clinical symptoms was noted. In five patients (25%) with polycystic liver disease, recurrence of pain syndrome was reported.

Conclusion. The accumulated experience with percutaneous sclerotherapy supports its recommendation as a first-line treatment for solitary and multiple non-parasitic hepatic cysts as well as the treatment of choice for polycystic liver disease.

1. Freynd G.G., Zhivaeva E.V. The morphogenesis of nonparasitic liver cysts. Morphological Newsletter. 2020; 28 (3): 51–57. https://doi.org/10.20340/mv-mn.2020.28(3):51-57 (In Russian)

2. Ahaladze G.G., Nanetashvili M.G., Chevokin A.Yu., Galperin E.I. Surgical treatment of non-parasitic liver cysts. Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery. 1999; 4 (1): 29–33. (In Russian)

3. Sigua B.V., Zemlyanoy V.P., Kachiuri A.S., Gurjii D.V., Abdulaeva R.M., Vinnichuk S.A., Zakharov E.A. Endovideosurgery in treating large nonparasitic hepatic cysts. Herald of North-Western State Medical University named after I.I. Mechnikov. 2019; 11 (1): 55–60. https://doi.org/10.17816/mechnikov201911155-60 (In Russian)

4. Marrero J.A., Ahn J., Rajender Reddy K. ACG clinical guideline: the diagnosis and management of focal liver lesions. Am. J. Gastroenterol. 2014; 109 (9): 1328–1347. https://doi.org/10.1038/ajg.2014.213.quiz1348

5. Debs T., Kassir R., Reccia I., Elias B., Ben Amor I., Iannelli A., Gugenheim J., Johann M. Technical challenges in treating recurrent non-parasitic hepatic cysts. Int. J. Surg. 2016; 25: 44–48. https://doi.org/10.1016/j.ijsu.2015.11.051

6. Rawla P., Sunkara T., Muralidharan P., Raj J.Р. An updated review of cystic hepatic lesions. Clin. Exp. Hepatol. 2019; 5 (1): 22–29. https://doi.org/10.5114/ceh.2019.83153

7. Starkov Yu.G., Vishnevskii V.A., Shishin K.V. An experience of laparoscipic operations in the liver local lesions. Annaly khirurgicheskoy gepatologii= Annals of HPB Surgery. 2008; 13 (1): 34–41. (In Russian)

8. Kotelnikova L.P., Busyrev Yu.B., Belyakova Ya.V. Nonparasitic hepatic cysts treatment. Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery. 2014; 19 (1): 60–67. (In Russian)

9. Gomez A., Wisneski A.D., Luu H.Y., Hirose K., Roberts J.P., Hirose R., Freise C.E., Nakakura E.K., Corvera C.U. Con temporary management of hepatic cyst disease: techniques and outcomes at a tertiary hepatobiliary center. J. Gastrointest. Surg. 2021; 25 (1): 77–84. https://doi.org/10.1007/s11605-020-04821-1

10. Akhan O., Islim F., Balci S., Erbahceci A., Akpınar B., Ciftci T., Akinci D. Percutaneous treatment of simple hepatic cysts: the long-term results of PAIR and catheterization techniques as single-session procedures. Cardiovasc. Intervent. Radiol. 2016; 39 (6): 902–908. https://doi.org/10.1007/s00270-015-1283-0

11. Zhavoronkova O.I. Management of larger then 10 cm nonparasitic liver cysts. Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery. 2007; 12 (2): 116–122. (In Russian)

12. Furumaya A., van Rosmalen B.V., de Graeff J.J., Haring M.P.D., de Meijer V.E., van Gulik T.M., Verheij J., Besselink M.G., van Delden O.M., Erdmann J.I.; Dutch Benign Liver Tumor Group. Systematic review on percutaneous aspiration and sclerotherapy versus surgery in symptomatic simple hepatic cysts. HPB (Oxford). 2021; 23 (1): 11–24. https://doi.org/10.1016/j.hpb.2020.07.005

13. Cherkasov M.F., Aboyan I.A., Aboyan M.E., Roshak B.V., Malikov L.L., Khanamirova L.Z., Bukharbaev R.M., Frolova G.V., Melikova S.G. Radiofrequency ablation in management of simple non-parasitic liver cysts. Annaly khirurgicheskoy gepatologii = Annals of HPB surgery. 2020; 25 (2): 86–99. https://doi.org/10.16931/1995-5464.2020286-99 (In Russian)

14. Norcia L.F., Watanabe E.M., Hamamoto Filho P.T., Hasimoto C.N., Pelafsky L., de Oliveira W.K., Sassaki L.Y. Polycystic liver disease: pathophysiology, diagnosis and treatment. Hepat. Med. 2022; 14: 135–161. https://doi.org/10.2147/HMER.S377530.