Hepatic cysts: treatment with alcohol.

Six patients with hepatic cysts were successfully treated with percutaneous aspiration and temporary direct injection of sterile alcohol U.S.P. (95% ethanol) into the cyst cavities through an aspiration catheter. Five cysts were treated percutaneously using sonographic guidance, and one cyst was treated under direct vision during a cholecystectomy. It is ideal to treat with 25% replacement volume of alcohol. The larger cysts may require more than one alcohol treatment at the same sitting to be effective. There was no recurrence of the treated cysts on follow-up examinations of 6-18 months. Minor complications of transient pain, temperature elevation, and hemorrhage into a cyst occurred. No major complications were encountered. The results of this series would indicate that aspiration and injection of alcohol is the treatment of choice for symptomatic congenital hepatic cysts.