This paper is only available as a PDF. To read, Please Download here.
Background. Occasionally patients with adult polycystic liver disease (APLD) have symptoms. For
these patients surgery may represent a valuable therapeutic option to relieve symptoms.
Methods. From September 1977 to August 1993 at our institution, 10 women with APLD were examined
and surgically treated. They underwent a partial hepatic resection together with cyst
fenestration. The surgical outcome and long-term follow-up were retrospectively analyzed.
Results. Postoperative morbidity consisted of one case of pneumonia, and one case of acute
pancreatitis with deep vein leg thrombosis. One patient died after acute Budd-Chiari
syndrome developed as a result of liver collapse after fenestration of a posterior
cyst. In the long term six of nine patients were symptom free. Late surgical complications
included acute cholecystitis (one patient), small bowel obstruction (one), and incisional
hernia (two).
Conclusions. A combined surgical approach of hepatic resection and cyst fenestration has proved
feasible for patients with highly symptomatic APLD. Extensive fenestration of posterior
cysts should be avoided; transverse hepatic resection (frontal hepatectomy) up to
the costal margin is proposed. This therapy provides good results at long-term follow-up.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Adult polycystic disease of the liver.Br J Surg. 1991; 78: 524-527
- Partial resection and fenestration in the treatment of polycystic liver disease.Br J Surg. 1984; 71: 242-244
- Personal experience with 411 hepatic resections.Ann Surg. 1988; 208: 421-434
- Treatment of highly symptomatic polycystic liver disease.Ann Surg. 1990; 212: 30-37
- Surgical management of nonparasitic cystic liver disease.Am J Surg. 1991; 161: 113-119
- Clinical experience with adult polycystic liver disease.Br J Surg. 1992; 79: 562-565
- Non-parasitic liver cysts and polycystic liver disease results of surgical treatment.Hepatogastroenterology. 1993; 40: 1-5
- Résection hépatique pour polykystose hépato-rénale.Ann Chir. 1993; 47 ([Abstract]): 1058
- Nonsurgical treatment for symptomatic nonparasitic liver cyst.Am J Gastroenterol. 1985; 80: 907-911
- Percutaneous aspiration and alcohol sclerotherapy for symptomatic hepatic cysts.Ann Surg. 1989; 210: 208-215
- Treatment of non-parasitic cystic disease of the liver: a new approach to therapy with polycystic liver.Ann Surg. 1968; 168: 921-927
- Surgical anatomy and anatomical surgery of the liver.World J Surg. 1982; 6: 3-9
- Adult polycystic liver disease and biliary microhamartomas (Von Meyenburg's complexes).Acta Pathol Microbiol Immunol Scand. 1986; 94: 397-400
- Massive hepatomegaly in adult polycystic liver disease.Am J Surg Pathol. 1988; 12: 321-324
- Liver cysts in patients with autosomal dominant polycystic kidney disease.Am J Med. 1980; 68: 741-744
- Frequency of hepatic cysts in adult polycystic kidney disease.Acta Med Scand. 1988; 224: 381-384
- Liver changes and complications in adult polycystic kidney disease.Adv Nephrol. 1985; 14: 1-20
- Non-parasitic cyst of the liver: a clinical study of 117 cases.Ann Chir Gynecol. 1970; 59: 1-63
- Bleeding oesophageal varices and hepatic dysfunction in adult polycystic liver disease.Br Med J. 1984; 288: 1330-1331
- Jaundice associated with polycystic liver disease.Am J Surg. 1978; 138: 383-386
- Epidemiology of adult polycystic kidney disease: Olmsted County, Minnesota—1935–1980.Am J Kidney Dis. 1983; 2: 630-639
- Percutaneous aspiration of hepatic cysts does not provide definitive therapy.AJR. 1983; 141: 559-560
- Highly symptomatic adult polycystic disease of the liver.J Hepatol. 1987; 5: 109-117
- Laparoscopic managment of symptomatic non parasitic cysts of the liver: indications and results.Ann Surg. 1994; 219: 157-164
- Polycystic liver disease: quantitation of parenchymal and cysts volumes from computed tomography images and clinical correlates of hepatic cysts.Hepatology. 1988; 8: 1627-1634
- Syndrome aigu de Budd-Chiari après traitement chirurgical d'une polykystose hépatique.Gastroenterol Clin Biol. 1992; 16: 894-896
- Left hepatic vein kinking after right hepatectomy: a rare cause of acute Budd-Chiari syndrome.Br J Surg. 1992; 79: 798-799
- Hepatic resection for cystic lesions of the liver.Ann Surg. 1993; 218: 610-614
- Liver transplantation for polycystic liver disease.Arch Surg. 1990; 125: 575-577
Article info
Publication history
Accepted:
July 27,
1994
Identification
Copyright
© 1995 Mosby-Year Book, Inc. Published by Elsevier Inc.
