title: Sclerotherapy of simple hepatic cysts by repeated aspiration and alcohol instillation.
abstract: OBJECTIVE
  The efficacy and safety of traditional alcohol sclerotherapy procedures are controversial in the management of large simple hepatic cysts. In this study, we aimed to develop and evaluate a novel alcohol sclerotherapy procedure, termed repeated aspiration and alcohol instillation sclerotherapy, for the treatment of simple hepatic cysts.
  
  
  METHODS
  A prospective, double-blind, randomized study was performed. Sixty-seven patients with large simple hepatic cysts were randomized into two groups to receive either single-session alcohol retention sclerotherapy (alcohol was instilled into the cyst cavity, kept for 20 minutes and aspirated) or repeated aspiration and alcohol instillation sclerotherapy (instillation of 30-70 ml of alcohol and immediate aspiration with repetition 3 to 6 times until the estimated alcohol concentration exceeded 80%). The cyst volume reduction was calculated to compare the efficacy of the two procedures. We evaluated the safety of the procedure by monitoring side effects and assaying blood alcohol concentrations at 0, 0.5, 1, 2 and 3 hours after sclerotherapy.
  
  
  RESULTS
  The cyst volume reduction in patients undergoing repeated aspiration and alcohol instillation sclerotherapy was significantly higher than that in those receiving alcohol-retention sclerotherapy. The concentration of alcohol in the last aspirated cyst fluid was correlated with the mean volume reduction in patients undergoing repeated aspiration and alcohol instillation sclerotherapy but not in the alcohol-retention group. Only minor side effects occurred in both groups. Although elevated blood alcohol concentration was noted in all patients, it declined to normal levels within 2-3 hours after treatment. There were no significant differences in blood alcohol concentration between the two groups.
  
  
  CONCLUSIONS
  Repeated aspiration and alcohol instillation sclerotherapy is superior to single-session alcohol-retention sclerotherapy in the management of large simple hepatic cysts.
authors.affiliation: Beijing Friendship Hospital, Capital Medical University, No 95 Yong'an Road, Xuanwu District Beijing 100050, PR China.
authors.forename: Feng
authors.initials: F
authors.lastname: Yan-Hong
authors.forename: Qian
authors.initials: Q
authors.lastname: Lin-Xue
authors.forename: Gong
authors.initials: G
authors.lastname: Hai-Ma
authors.forename: Zhang
authors.initials: Z
authors.lastname: Qing
authors.forename: Gui
authors.initials: G
authors.lastname: Yu
authors.forename: Hu
authors.initials: H
authors.lastname: Xiangdong
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle / Q000009:adverse effects; D003560:Cysts / Q000473:pathology / Q000628:therapy*; D004311:Double-Blind Method; D000431:Ethanol / Q000009:adverse effects / Q000097:blood / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007322:Instillation, Drug; D016014:Linear Models; D008107:Liver Diseases / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012597:Sclerosing Solutions / Q000009:adverse effects / Q000627:therapeutic use*; D015911:Sclerotherapy / Q000009:adverse effects / Q000379:methods*; D018709:Statistics, Nonparametric
chemical_list: D012597:Sclerosing Solutions; D000431:Ethanol