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.
Department of Gastroenterology, National Institute of Health Sciences and Nutrition Salvador Zubiran, Mexico City 14000, Mexico.
Josue
J
Barahona-Garrido
Jesus
J
Camacho-Escobedo
Eduardo
E
Cerda-Contreras
Jorge
J
Hernandez-Calleros
Jesus K
JK
Yamamoto-Furusho
Aldo
A
Torre
Misael
M
Uribe
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