Combined hepatic resection with fenestration for highly symptomatic polycystic liver disease: A report on seven patients.

AIM

To evaluate the immediate and long-term results in a series of patients with highly symptomatic polycystic liver disease (PLD) treated by combined hepatic resection with cystic fenestration.

METHODS

We reviewed our recent experience with a combined hepatic resection-fenestration procedure in seven highly symptomatic patients with PLD. Clinical data, liver manifestation of computed tomography (CT), and morbidity were recorded pre- and post-operation. Follow-up was made by clinical and CT examinations in all patients.

RESULTS

Symptomatic relief and reduction in abdominal girth were obtained in all patients during an average follow-up period of 20.4 mo. CT scans confirmed post-resection hypertrophy of the spared liver and lack of significant cyst progression. All patients had mild to severe ascites. Two patients were complicated with pleural effusion.

CONCLUSION

Some highly symptomatic patients with massive PLD may benefit from combined hepatic resection and fenestration at acceptable risk. To stitch the dissected hepatic ligaments could prevent the instable remnant liver from kinking and collapsing.