Eso Yuji, Shimizu Hironori, Takai Atsushi, Takahashi Ken, Seno Hiroshi
Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Hepatol Res. 2022 Jun;52(6):557-565. doi: 10.1111/hepr.13769. Epub 2022 Apr 11.
Simple hepatic cysts are typically benign; however, when they are large and symptomatic, therapeutic intervention is required. We previously reported our initial experience with ultrasound (US)-guided polidocanol foam sclerotherapy in three patients with symptomatic giant hepatic cysts. In the present study, we examined the efficacy and safety of polidocanol foam sclerotherapy in a larger number of patients with long-term follow-up.
Between May 2016 and April 2021, 15 patients with symptomatic giant hepatic cysts were referred to our hospital. All patients were prospectively included in the study and underwent US-guided polidocanol foam sclerotherapy.
The mean maximum diameter and estimated cyst volume were 128.4 mm (77-223 mm) and 922.3 ml (123.2-2797 ml), respectively. Polidocanol foam was successfully administered through an 8.5-Fr pigtail catheter in all patients. The percentages of cyst diameter/volume after 1-3 months, 3-6 months, 6 months-1 year, 1-2 years, and 2-4 years of sclerotherapy were 66.8%/36.5%, 48.1%/14.8%, 34.1%/6.9%, 28.2%/3.7%, and 26.2%/3.1%, respectively. During the follow-up period, there were no cases of symptom recurrence or need for additional treatment due to cyst re-growth. Six patients (40%) had fever, one had nausea, and one had right-sided chest pain, but none of these adverse events required prolonged hospitalization or readmission.
US-guided polidocanol foam sclerotherapy may be an effective and safe method for the treatment of symptomatic giant hepatic cysts.
单纯性肝囊肿通常为良性；然而，当囊肿较大且有症状时，则需要进行治疗干预。我们之前报告了3例有症状的巨大肝囊肿患者接受超声（US）引导下聚多卡醇泡沫硬化治疗的初步经验。在本研究中，我们对更多患者进行了长期随访，以检验聚多卡醇泡沫硬化治疗的疗效和安全性。
2016年5月至2021年4月期间，15例有症状的巨大肝囊肿患者被转诊至我院。所有患者均被前瞻性纳入本研究，并接受了超声引导下聚多卡醇泡沫硬化治疗。
平均最大直径和估计囊肿体积分别为128.4毫米（77 - 223毫米）和922.3毫升（123.2 - 2797毫升）。所有患者均通过8.5F猪尾导管成功注入聚多卡醇泡沫。硬化治疗后1 - 3个月、3 - 6个月、6个月至1年、1 - 2年和2 - 4年时囊肿直径/体积的缩小百分比分别为66.8%/36.5%、48.1%/14.8%、34.1%/6.9%、28.2%/3.7%和26.2%/3.1%。在随访期间，没有症状复发或因囊肿再生长而需要额外治疗的病例。6例患者（40%）出现发热，1例出现恶心，1例出现右侧胸痛，但这些不良事件均未导致延长住院时间或再次入院。
超声引导下聚多卡醇泡沫硬化治疗可能是一种治疗有症状巨大肝囊肿的有效且安全的方法。
