To describe the generalities about the percutaneous sclerotherapy treatment approach of the symptomatic liver cysts. To describe the procedure in a practical way. To mention the main indications,
and results over a period of time. To show the existing clinical evidence about the procedure.
Background Cystic hepatic lesions are commonly encountered in daily practice.
The differential diagnoses range from benign lesions of no clinical significance to malignant and potentially lethal conditions. Hepatic cysts are the most commonly encountered hepatic lesion,
occurring in 2.5% of the general population,
and have a slight predominance in females (female-male ratio,
Hepatic cysts are thought to be of biliary origin as a result of deranged development of the biliary tree,
Findings and procedure details
Procedure Contraindications are the severe coagulopathy,
communication between cyst and biliary tract or peritoneal cavity,
and incapacity to recover the contrast medium from the cyst. Conscious sedation is generally achieved with intravenous midazolam and fentanyl,
under constant hemodynamic monitoring. Typically the cyst is punctured under sonographic guidance,
and an 8 to 10F pigtail catheter is inserted into the cyst,
through 1-3 cm of liver tissue to prevent leakage from the cyst,
Liver cysts are very common in general population.
Most are incidental findings,
but when large they can be symptomatic.
Treatment options include surgery,
and sclerotherapy. In the appropriate setting,
percutaneous sclerotherapy is effective in the management of symptomatic cystic lesions,
with low rate of complications and high rate of reduction or complete resolution of symptoms.
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Single-session alcohol sclerotherapy of symptomatic liver cysts using 10-20 min of ethanol exposure: no recurrence at 2-16 years of follow-up.
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