Factors that influence outcome in non-invasive and invasive treatment in polycystic liver disease patients.
OBJECTIVE
To evaluate the factors that influence outcome of both non-invasive and invasive treatment of polycystic liver disease.


METHODS
Analysis of clinical files of patients with complete follow-up from July 1986 to June 2006.


RESULTS
Forty-one patients (male, 7; female, 34), 47.8 +/- 11.9 years age, and 5.7 +/- 6.7 years follow-up, were studied. Alkaline phosphatase (AP) elevation (15% of patients) was associated with the requirement of invasive treatment (IT, P = 0.005). IT rate was higher in symptomatic than non-symptomatic patients (65.4% vs 14.3%, P = 0.002), and in women taking hormonal replacement therapy (HRT) (P = 0.001). Cysts complications (CC) were more frequent (22%) in the symptomatic patients group (P = 0.023). Patients with body mass index (BMI) > 25 (59%) had a trend to complications after IT (P = 0.075). Abdominal pain was the most common symptom (56%) and indication for IT (78%). Nineteen patients (46%) required a first IT: 12 open fenestration (OF), 4 laparoscopic fenestration (LF) and 3 fenestration with hepatic resection (FHR). Three required a second IT, and one required a third procedure. Complications due to first IT were found in 32% (OF 16.7%, LF 25%, FHR 66.7%), and in the second IT in 66.7% (OF 100%). Follow-up mortality rate was 0.


CONCLUSIONS
Presence of symptoms, elevated AP, and CC are associated with IT requirement. HRT is associated with presence of symptoms and IT requirement. Patients with BMI > 25 have a trend be susceptible to IT complications. The proportions of complications are higher in FHR and second IT groups. RS is more frequent after OF.
Barahona-Garrido
Josue
J
Department of Gastroenterology, National Institute of Health Sciences and Nutrition Salvador Zubiran, Mexico City 14000, Mexico.
Camacho-Escobedo
Jesus
J
Cerda-Contreras
Eduardo
E
Hernandez-Calleros
Jorge
J
Yamamoto-Furusho
Jesus K
JK
Torre
Aldo
A
Uribe
Misael
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000469:Alkaline Phosphatase / Q000097:blood; D015992:Body Mass Index; D003560:Cysts / Q000150:complications / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D013505:Digestive System Surgical Procedures / Q000009:adverse effects; D015914:Estrogen Replacement Therapy / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008107:Liver Diseases / Q000150:complications / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012008:Recurrence; D012086:Reoperation; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome
D000469:Alkaline Phosphatase