title: Is fenestration a safe treatment for adult polycystic liver disease?: A report of refractory complications.
abstract: We report a 67-year-old man with highly symptomatic polycystic liver disease. Fenestration was selected to treat symptoms because the cysts were scattered diffusely and the normal liver volume was limited. Although this patient was relieved from symptoms of liver cysts consequently, several severe postoperative complications including disseminated intravascular coagulation, respiratory failure, liver failure, and biliary leakage occurred resulting in a 6-month postoperative hospital stay. Although various treatments for symptomatic adult polycystic liver disease have been advocated, a definitive treatment remains controversial, especially in diffuse adult polycystic liver disease. Fenestration is one of the alternative treatments for the patients whose cysts are difficult to resect. However high morbidity rate should be carefully assessed, if extensive fenestration is needed to treat diffuse adult polycystic liver disease. Further consideration of appropriate treatments for diffuse adult polycystic liver disease is needed.
authors.affiliation: Department of Surgery, Showa University Fujigaoka Hospital, Yokohama, Japan. k-ishibashi@showa-university-fujigaoka.gr.jp
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Ishibashi
authors.forename: Takemasa
authors.initials: T
authors.lastname: Midorikawa
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kikuchi
authors.forename: Yasurou
authors.initials: Y
authors.lastname: Fujiwara
authors.forename: Hisanori
authors.initials: H
authors.lastname: Izuno
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Hatakeyama
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Saito
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Miyakawa
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Mizukami
authors.forename: Kouji
authors.initials: K
authors.lastname: Maezawa
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nemoto
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Sanada
mesh_terms: D000368:Aged; D001646:Bile / Q000378:metabolism; D001658:Biliary Fistula / Q000209:etiology / Q000378:metabolism; D003560:Cysts / Q000000981:diagnostic imaging / Q000601:surgery*; D013505:Digestive System Surgical Procedures / Q000009:adverse effects; D004211:Disseminated Intravascular Coagulation / Q000209:etiology; D006801:Humans; D007902:Length of Stay; D008107:Liver Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D017093:Liver Failure / Q000209:etiology; D008297:Male; D011184:Postoperative Period; D011300:Preoperative Care; D011877:Radionuclide Imaging; D012131:Respiratory Insufficiency / Q000209:etiology; D014057:Tomography, X-Ray Computed; D014684:Venae Cavae / Q000000981:diagnostic imaging