title: Percutaneous aspiration and ethanolamine oleate sclerotherapy for sustained resolution of symptomatic polycystic liver disease: an initial experience.
abstract: OBJECTIVE
  Surgical therapy for symptomatic polycystic liver disease is effective but has substantial mortality and morbidity. Minimally invasive options such as percutaneous aspiration with or without ethanol sclerosis have had disappointing results. The purpose of this study was to evaluate percutaneous aspiration with ethanolamine oleate sclerosis in the management of symptomatic polycystic liver disease.
  
  
  METHODS
  The study included 13 patients (11 with polycystic liver disease, two with simple cysts) with 17 cysts. All patients underwent percutaneous aspiration of the liver cyst under ultrasound guidance followed by insertion of a 7-French pigtail catheter, instillation of ethanolamine oleate (10% of cyst volume), and aspiration of the ethanolamine oleate. The catheter was kept in place for 24 hours of open drainage and then removed.
  
  
  RESULTS
  All but one of the cysts resolved with one instillation. The one cyst, in a patient with polycystic liver disease, required two instillations 3 months apart. The mean initial volume of cysts was 589.8 mL, and the mean reduction in volume was 88.8%. Both the simple cysts resolved completely. In the cases of polycystic disease, the volume of cysts larger than 10 cm in diameter was reduced by 92.8%. Cyst resolution was gradual, and clinically significant cyst reduction was achieved within 1 year of therapy. None of the patients needed surgery. The median follow-up period was 54 months (range, 1 week-95 months). There were no significant adverse effects, and all patients had relief of symptoms after therapy.
  
  
  CONCLUSIONS
  This initial experience with a single session of percutaneous aspiration and ethanolamine oleate sclerosis resulted in sustained resolution of symptomatic polycystic liver disease with minimal morbidity, avoidance of surgery, and improvement in quality of life.
authors.affiliation: Department of Gastroenterology and Hepatology, Kinki University School of Medicine, 377-2 Onho-Higashi, Osaka-sayama, Osaka, Japan.
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Nakaoka
authors.forename: Kunal
authors.initials: K
authors.lastname: Das
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Kudo
authors.forename: Hobyung
authors.initials: H
authors.lastname: Chung
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Innoue
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D003560:Cysts / Q000628:therapy*; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009829:Oleic Acids / Q000627:therapeutic use*; D012597:Sclerosing Solutions / Q000627:therapeutic use*; D015911:Sclerotherapy / Q000379:methods*; D013396:Suction / Q000379:methods*; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
chemical_list: D003287:Contrast Media; D009829:Oleic Acids; D012597:Sclerosing Solutions; C033343:ethanolamine oleate