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Kim R, Oh JS, Kim SH, Chun HJ. Complete and Incomplete Alcohol Sclerotherapy for Treatment of Symptomatic Hepatic Cysts: Comparison of Volume Reduction and Clinical Outcomes. J Clin Med 2024; 13:1472. [PMID: 38592276 PMCID: PMC10932187 DOI: 10.3390/jcm13051472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Revised: 02/09/2024] [Accepted: 03/01/2024] [Indexed: 04/10/2024] Open
Abstract
Background: The purpose of this study was to compare the efficacy of incomplete alcohol sclerotherapy with complete treatment for hepatic cysts. Methods: From 2005 to 2021, a total of 80 patients (19 males, 61 females; median age 65 years; age range, 42-86 years) who underwent alcohol sclerotherapy for symptomatic benign hepatic cysts were enrolled and retrospectively reviewed. Complete treatment was defined as injecting 25-33% of the aspirated cyst volume with alcohol in 2-3 cycles, with a maximum of 100 mL per cycle. The overall volume reduction rate was compared between the complete and incomplete treatment groups. The response, based on cystic volume reduction, was classified as a complete regression (CR), near-complete regression (NCR), partial regression (PR), or no response (NR). CR and NCR were considered objective responses. Among 80 patients with 85 hepatic cysts, 26 patients with 29 hepatic cysts received incomplete treatment. Results: The overall volume reduction rate was not significantly different between the complete and incomplete treatment groups (94.39% vs. 95.47%, respectively, p = 0.623). The CR and NCR groups showed a significantly higher rate of symptom improvement than the PR and NR groups (p = 0.043). Conclusions: In conclusion, the efficacy of incomplete alcohol sclerotherapy was not inferior to that of complete treatment.
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Affiliation(s)
- Ran Kim
- Department of Radiology, Chung-Ang University Gwang Myeong Hospital, Chung-Ang University College of Medicine, Gwang Myeong 14353, Republic of Korea;
| | - Jung-Suk Oh
- Department of Radiology, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul 06591, Republic of Korea; (S.-H.K.); (H.-J.C.)
| | - Su-Ho Kim
- Department of Radiology, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul 06591, Republic of Korea; (S.-H.K.); (H.-J.C.)
| | - Ho-Jong Chun
- Department of Radiology, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul 06591, Republic of Korea; (S.-H.K.); (H.-J.C.)
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Yoshitomi K, Koya Y, Miyagawa K, Maruno Y, Yamaguchi K, Taniguchi R, Onitsuka K, Sakamoto Y, Oe S, Harada M. Symptomatic Liver Cyst Successfully Treated with Transgastric Drainage and Sclerotherapy Using Minocycline Hydrochloride. Case Rep Gastrointest Med 2024; 2024:6942345. [PMID: 38273972 PMCID: PMC10807977 DOI: 10.1155/2024/6942345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 12/18/2023] [Accepted: 12/21/2023] [Indexed: 01/27/2024] Open
Abstract
A liver cyst is hepatic fluid-filled cavities often detected in clinical surveillances such as a health examination. Although the liver cyst is usually asymptomatic and observed without any therapeutic intervention, it can be symptomatic and needs treatment due to its enlargement, hemorrhage, and infection. A 74-year-old woman presented with upper abdominal pain and a huge liver cyst in the left lobe. Several examinations including image findings revealed that the symptom could be derived from the liver cyst. Although there is no definite guideline of treatment for symptomatic liver cysts, percutaneous ultrasound-guided drainage with sclerotherapy or surgery is often selected. Because of anatomical accessibility to the liver cyst and the patient's wish, we performed endoscopic transgastric drainage with insertion of both an internal stent and an external nasocystic tube. Sclerotherapy with minocycline hydrochloride was performed through the nasocystic tube, and the liver cyst shrunk completely without any complications. This is the first reported method of administering minocycline hydrochloride through a nasocystic tube, which can be a therapeutic option for patients with symptomatic liver cysts.
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Affiliation(s)
- Kengo Yoshitomi
- Department of Gastroenterology, Kyushu Rosai Hospital, Moji Medical Center, Kitakyushu, Japan
- The Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Yudai Koya
- Department of Gastroenterology, Kyushu Rosai Hospital, Moji Medical Center, Kitakyushu, Japan
- The Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Koichiro Miyagawa
- The Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Yuki Maruno
- Department of Gastroenterology, Kyushu Rosai Hospital, Moji Medical Center, Kitakyushu, Japan
- The Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Koki Yamaguchi
- Department of Gastroenterology, Kyushu Rosai Hospital, Moji Medical Center, Kitakyushu, Japan
- The Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Ryuta Taniguchi
- Department of Surgery, Kyushu Rosai Hospital, Moji Medical Center, Kitakyushu, Japan
| | - Koji Onitsuka
- Department of Surgery, Kyushu Rosai Hospital, Moji Medical Center, Kitakyushu, Japan
| | - Yoshitaka Sakamoto
- Department of Surgery, Kyushu Rosai Hospital, Moji Medical Center, Kitakyushu, Japan
| | - Shinji Oe
- The Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Masaru Harada
- The Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
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Pfahl M, Gallaher HM. Successful minimally invasive simple hepatic cyst ablation via ethanol sclerotherapy in a cat. JFMS Open Rep 2023; 9:20551169231215273. [PMID: 38115861 PMCID: PMC10729625 DOI: 10.1177/20551169231215273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023] Open
Abstract
Case summary A 12-year-old neutered male domestic shorthair cat was evaluated at the Michigan State University Veterinary Medical Center (MSU-VMC) for an abdominal cyst that was initially noted on ultrasound 1 year prior by the referring veterinarian. The cystic mass was causing clinical signs, including vomiting, diarrhea, hyporexia and abdominal pain. Cyst drainage had originally been performed every few months, but by referral, the required frequency of drainage had increased to every 2 weeks for a total of eight drainage events; therefore, a more definitive curative option was sought. CT evaluation revealed a large simple hepatic cyst - largest diameter 7.2 cm - likely associated with the right medial liver lobe. Minimally invasive ethanol sclerotherapy was performed. A locking-loop catheter was placed percutaneously and transhepatically into the cyst using ultrasound guidance. The cyst was drained, and contrast injected under fluoroscopic guidance to ensure no communication between the cyst and liver. Sclerotherapy was performed using a volume of 99.5% ethanol calculated from the volume of cyst fluid removed. The patient was discharged on the same day and had complete resolution of clinical signs. At a 6-month follow-up, the cyst had decreased in volume by an estimated 95%. The patient remains asymptomatic more than 1 year postoperatively. Relevance and novel information To our knowledge, this is the first report of a feline hepatic cyst treated via percutaneous transhepatic ethanol ablation. Minimally invasive simple hepatic cyst ablation is a viable treatment option in cats that could avoid the need for a more invasive surgical intervention.
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Affiliation(s)
- Madison Pfahl
- Veterinary Medical Center, Michigan State University, East Lansing, MI, USA
| | - Hayley M Gallaher
- Veterinary Medical Center, Michigan State University, East Lansing, MI, USA
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Eso Y, Shimizu H, Takai A, Takahashi K, Seno H. Ultrasound-guided polidocanol foam sclerotherapy for symptomatic giant hepatic cyst: A single-center experience. Hepatol Res 2022; 52:557-565. [PMID: 35355375 DOI: 10.1111/hepr.13769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 02/16/2022] [Accepted: 03/11/2022] [Indexed: 02/08/2023]
Abstract
AIM 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. METHODS 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. RESULTS 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. CONCLUSIONS US-guided polidocanol foam sclerotherapy may be an effective and safe method for the treatment of symptomatic giant hepatic cysts.
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Affiliation(s)
- Yuji Eso
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hironori Shimizu
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Atsushi Takai
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Ken Takahashi
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hiroshi Seno
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Aapkes SE, Bernts LH, van den Berg M, Gansevoort RT, Drenth JP. Tamoxifen for the treatment of polycystic liver disease: A case report. Medicine (Baltimore) 2021; 100:e26797. [PMID: 34397882 PMCID: PMC8360467 DOI: 10.1097/md.0000000000026797] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 07/12/2021] [Indexed: 01/04/2023] Open
Abstract
RATIONALE Polycystic liver disease is a rare disease characterized by the growth of numerous cysts in the liver. The liver function remains well preserved, but liver volumes can grow very large, and some patients ultimately need a liver transplantation. Other treatment options are limited and there is an unmet need for new therapeutic options. PATIENT CONCERNS We describe a 59-year-old patient with pain in the abdomen, especially when bending forward. Five years ago, she was diagnosed with breast cancer and as an incidental finding a couple of large liver cysts were diagnosed, explaining her abdominal pain. DIAGNOSIS Polycystic liver disease with several large liver cysts. INTERVENTIONS The patient was treated with tamoxifen, an estrogen receptor modulator, as treatment for her hormone receptor positive breast cancer. One of the liver cysts was aspirated. OUTCOMES In the 4.6 years after the start of tamoxifen treatment, 20 mg once daily, the volume of her liver cysts decreased remarkably. There was a reduction of combined cyst volume from 311 mL to 22 mL without percutaneous drainage. LESSONS Epidemiological as well as experimental evidence supports a pivotal role for estrogens as a driver for growth of polycystic livers. Estrogen antagonism has often been proposed as a therapeutic target, but supporting evidence is lacking in the literature. We hypothesize that the decrease in cyst size in this patient was caused by tamoxifen therapy, suggesting an in vivo antagonistic effect on cystic cholangiocytes. This is an important finding because tamoxifen could be a promising new treatment option for polycystic liver disease.
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Affiliation(s)
- Sophie E. Aapkes
- Department Nephrology, University Medical Center, Groningen, The Netherlands
| | - Lucas H.P. Bernts
- Department Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - M. van den Berg
- Department Gynecology, University Medical Center, Groningen, The Netherlands
| | - Ron T. Gansevoort
- Department Nephrology, University Medical Center, Groningen, The Netherlands
| | - Joost P.H. Drenth
- Department Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, The Netherlands
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Yang F, Qian Z, Sun F, Chen K, Fan L, Duan J, Wang Q, Asakawa T, Zheng S. Laparoscopic Enucleation of Hepatic Cysts Reduces the Recurrence of Nonparasitic Hepatic Cysts. J Laparoendosc Adv Surg Tech A 2020; 31:314-319. [PMID: 32552410 DOI: 10.1089/lap.2019.0829] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Standard treatments for nonparasitic hepatic cysts (NPHCs) include laparoscopic deroofing (LD), percutaneous aspiration, and alcohol sclerotherapy. However, these treatments have limitations. LD and alcohol sclerotherapy, for example, fail to prevent NPHC recurrences, although alcohol sclerotherapy is satisfactorily effective in treating small cysts (diameter <5 cm), which do not usually need treatment. The present study introduces a novel surgical procedure, laparoscopic enucleation with intact cyst (LEIC), which may prevent postoperative cyst recurrence. Materials and Methods: In this study, we enrolled 14 patients, with NPHCs larger than 9 cm in diameter, who underwent LEIC. Dissection and coagulation were performed using the harmonic shear enucleation and bipolar coagulation techniques. We attempted to completely remove the cysts intact. Results: For all patients, symptoms disappeared after complete elimination of the cyst capsule. No complications (hemorrhage or bile leakage) were found during the perioperative period. The mean follow-up period was 19.3 months (range 10-38 months), during which no recurrences or complications were noted. Conclusions: LEIC is a novel surgical approach that shows satisfactory efficacy and safety in patients with large, surficial, and symptomatic NPHCs. LEIC's main advantage is that it can efficiently prevent cyst recurrence and decrease postoperative morbidity. However, its long-term efficacy and safety require further verification, especially with huge cysts.
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Affiliation(s)
- Fuchun Yang
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Ze Qian
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Fei Sun
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Kangjie Chen
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Le Fan
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jixuan Duan
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Qiong Wang
- Hangzhou Changgentang Clinic of TCM, Hangzhou, China
| | - Tetsuya Asakawa
- Department of Neurosurgery, Hamamatsu University School of Medicine, Hamamatsu, Japan.,Research Base of Traditional Chinese Medicine Syndrome, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Shusen Zheng
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,NHFPC Key Laboratory of Combined Multi-Organ Transplantation, Hangzhou, China
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7
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Han K, Seo SK, Kim MD, Kim GM, Kwon JH, Kim HJ, Won JY, Lee DY. Catheter-directed Sclerotherapy for Ovarian Endometrioma: Short-term Outcomes. Radiology 2018; 289:854-859. [PMID: 30152743 DOI: 10.1148/radiol.2018180606] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2024]
Abstract
Purpose To evaluate the effectiveness of catheter-directed sclerotherapy (CDS) with 95% ethanol in patients with primary or recurrent ovarian endometriomas. Materials and Methods In this prospective study, 14 participants (mean age, 32 years; range, 20-44 years) who underwent CDS for ovarian endometrioma from March 2015 to December 2017 were evaluated. Diagnosis was based on symptoms and imaging studies. To assess the impact of CDS on ovarian reserve, serum anti-Müllerian hormone (AMH) was measured before CDS and 6 months after CDS. Serum cancer antigen 125 (CA-125) levels were also measured at the same time points. Follow-up US was performed 1, 3, and 6 months after CDS and biannually thereafter to monitor potential cyst size change and recurrence. Comparison of AMH, CA-125, and cyst size before and after CDS was performed by using the paired t test or Wilcoxon signed-rank test. Results Mean endometrioma size decreased from 5.8 cm ± 2.2 to 1.1 cm ± 1 (P ˂ .001). During a mean follow-up of 12.7 months (range, 6.1-23.0 months), there were no recurrences of endometrioma. Pain was relieved in all participants, with a decrease in serum CA-125 level (P = .001). There was no difference in serum AMH level before and 6 months after CDS, indicating well-preserved ovarian function (4.29 ng/mL ± 2.47 vs 4.36 ng/mL ± 1.94, respectively; P > .875). There were no procedure-related complications. Conclusion Catheter-based sclerotherapy with 95% ethanol can lead to better short-term clinical outcomes and well-preserved ovarian function for patients with endometriomas. © RSNA, 2018.
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Affiliation(s)
- Kichang Han
- From the Department of Radiology (K.H., M.D.K., G.M.K., J.H.K., H.J.K., J.Y.W., D.Y.L.) and Division of Gynecologic Endocrinology, Department of Obstetrics and Gynecology (S.K.S.), Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, 50-1 Yonsei-ro Seodaemun-gu, Seoul 03722, Korea
| | - Seok Kyo Seo
- From the Department of Radiology (K.H., M.D.K., G.M.K., J.H.K., H.J.K., J.Y.W., D.Y.L.) and Division of Gynecologic Endocrinology, Department of Obstetrics and Gynecology (S.K.S.), Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, 50-1 Yonsei-ro Seodaemun-gu, Seoul 03722, Korea
| | - Man-Deuk Kim
- From the Department of Radiology (K.H., M.D.K., G.M.K., J.H.K., H.J.K., J.Y.W., D.Y.L.) and Division of Gynecologic Endocrinology, Department of Obstetrics and Gynecology (S.K.S.), Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, 50-1 Yonsei-ro Seodaemun-gu, Seoul 03722, Korea
| | - Gyoung Min Kim
- From the Department of Radiology (K.H., M.D.K., G.M.K., J.H.K., H.J.K., J.Y.W., D.Y.L.) and Division of Gynecologic Endocrinology, Department of Obstetrics and Gynecology (S.K.S.), Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, 50-1 Yonsei-ro Seodaemun-gu, Seoul 03722, Korea
| | - Joon Ho Kwon
- From the Department of Radiology (K.H., M.D.K., G.M.K., J.H.K., H.J.K., J.Y.W., D.Y.L.) and Division of Gynecologic Endocrinology, Department of Obstetrics and Gynecology (S.K.S.), Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, 50-1 Yonsei-ro Seodaemun-gu, Seoul 03722, Korea
| | - Hee Joon Kim
- From the Department of Radiology (K.H., M.D.K., G.M.K., J.H.K., H.J.K., J.Y.W., D.Y.L.) and Division of Gynecologic Endocrinology, Department of Obstetrics and Gynecology (S.K.S.), Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, 50-1 Yonsei-ro Seodaemun-gu, Seoul 03722, Korea
| | - Jong Yun Won
- From the Department of Radiology (K.H., M.D.K., G.M.K., J.H.K., H.J.K., J.Y.W., D.Y.L.) and Division of Gynecologic Endocrinology, Department of Obstetrics and Gynecology (S.K.S.), Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, 50-1 Yonsei-ro Seodaemun-gu, Seoul 03722, Korea
| | - Do Yun Lee
- From the Department of Radiology (K.H., M.D.K., G.M.K., J.H.K., H.J.K., J.Y.W., D.Y.L.) and Division of Gynecologic Endocrinology, Department of Obstetrics and Gynecology (S.K.S.), Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, 50-1 Yonsei-ro Seodaemun-gu, Seoul 03722, Korea
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Eso Y, Furuta A, Takai A, Takahashi K, Ueda Y, Marusawa H, Seno H. Ultrasound-guided microfoam sclerotherapy with polidocanol for symptomatic giant hepatic cyst: Initial experience. Hepatol Res 2018; 48:1055-1063. [PMID: 29882287 DOI: 10.1111/hepr.13202] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 05/12/2018] [Accepted: 06/01/2018] [Indexed: 12/26/2022]
Abstract
AIM In cases of symptomatic giant hepatic cysts, appropriate treatment is required to relieve symptoms. Ethanol, minocycline hydrochloride, and ethanolamine oleate have been conventionally used for ultrasound (US)-guided sclerotherapy. However, liquid sclerosing agents could mix with the residual fluid in the cyst and reduce their sclerotic effects. We carried out US-guided microfoam sclerotherapy using polidocanol for three patients and evaluated its efficacy and safety. METHODS Between May 2016 and March 2017, three female patients with symptomatic giant hepatic cysts were referred to our hospital. All of them were prospectively included in this study. RESULTS The maximum diameters of the hepatic cysts in the three patients were 92 × 89 × 86 mm, 155 × 119 × 140 mm, and 223 × 195 × 123 mm, respectively. Polidocanol microfoam was successfully administered through an 8.5-Fr pigtail catheter for all patients. One, two, and three microfoam sclerotherapy sessions were undertaken according to the initial cyst volume for cases 1, 2, and 3, respectively. The mean reduction rates of the cyst volume were 90.1% (85.5-98.9%) at 3 months, 96.3% (91.9-99.9%) at 6 months, and 99.5% (99.1-99.9%) at 9 months after treatment. No significant treatment-induced adverse effects were observed. CONCLUSION Ultrasound-guided microfoam sclerotherapy using polidocanol could be an effective and safe method for the treatment of symptomatic giant liver cysts.
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Affiliation(s)
- Yuji Eso
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Akihiro Furuta
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Atsushi Takai
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Ken Takahashi
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yoshihide Ueda
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hiroyuki Marusawa
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, Osaka, Japan
| | - Hiroshi Seno
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Percutaneous US-guided combined ethanol and tetracycline injection for treating symptomatic simple and hydatid hepatic cysts. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2018. [DOI: 10.1016/j.ejrnm.2018.04.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
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10
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[Surgical management of endometrioma: Different alternatives in term of pain, fertility and recurrence. CNGOF-HAS Endometriosis Guidelines]. ACTA ACUST UNITED AC 2018; 46:278-289. [PMID: 29510964 DOI: 10.1016/j.gofs.2018.02.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Indexed: 11/22/2022]
Abstract
Surgical management of ovarian endometrioma is most often part of a global approach of endometriosis pathology. Isolated endometrioma are rare. Laparoscopic cystectomy is the gold standard for surgical management of endometrioma. Nevertheless, this technique impacts the ovarian function. The hemostasis of the ovarian cyst bed should be performed to conserve the ovarian stroma. Ultrasonography-guided cyst aspiration, laparoscopic drainage and simple bipolar coagulation are not recommended as first line of treatment. Based on the actual literature, we cannot state the place of laser-vaporization and plasma-energy ablation in surgical management. Ethanol sclerotherapy could be an alternative to treat recurrent endometrioma. Uncompleted surgical removal of endometriosis lesions increases the recurrence rate. Endometriosis management should take into account the research and treatment of all the pelvic lesion, especially before surgical management of endometrioma. In this context, the evaluation of ovarian reserve could be useful before surgery.
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