The Treatment Effects of Percutaneous Drainage with or without Sclerotherapy for Symptomatic Liver Cysts
Abstract
:1. Introduction
2. Results
2.1. Patient Characteristics upon Initial Treatment
2.2. Factors Associated with Recurrence of Symptoms Due to Liver Cysts in Patients Treated via the Percutaneous Approach
2.3. Impact of Sclerosing Agents on Cumulative Recurrence Rates of Symptoms Due to Liver Cysts in Patients Treated via the Percutaneous Approach
2.4. Impact of Sclerosing Agents on Cumulative Recurrence Rates of Symptoms Due to Liver Cysts in Patients with a Maximum Liver Cyst Diameter of <16.5 cm
2.5. Impact of Sclerosing Agents on Cumulative Recurrence Rates of Symptoms Due to Liver Cysts in the Patients with a Maximum Liver Cyst Diameter of ≥16.5 cm
2.6. Demonstrable Cases
2.6.1. Case 1
2.6.2. Case 2
2.6.3. Case 3
2.7. Adverse Events and the Morbid Cases in the Present Study
3. Discussion
4. Patients and Methods
4.1. Patients
4.2. Demographics, Laboratory Data and Study Endpoints
4.3. Methods of Administering Each Sclerosing Agent to Liver Cysts
4.4. Ethical Considerations
4.5. Statistical Analyses
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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All Cases (n = 79) | Drainage Alone (n = 24) | Drainage with Sclerotherapy (n = 55) | p | |
---|---|---|---|---|
Age (years) | 70 (64–80) | 75 (67–83) | 69 (62–79) | 0.049 |
Male, n (%) | 20 (25.3) | 11 (45.8) | 9 (16.4) | 0.01 |
Complication with renal cysts, n (%) | 34 (43.0) | 12 (50) | 22 (40) | 0.46 |
Number of liver cysts, n (%) | ||||
<5 | 32 (40.5) | 8 (33.3) | 24 (43.6) | 0.58 |
5–10 | 21 (26.6) | 6 (25) | 15 (27.3) | |
>10 | 26 (32.9) | 10 (41.7) | 16 (29.1) | |
Maximum diameter of liver cysts (cm) | 13.1 (10.0–17.8) | 12.6 (8.8–18.1) | 13.1 (10.3–16.9) | 0.61 |
Symptoms, n (%) | ||||
Poor nutrition status with BMI < 18.5 kg/m2 | 3 (3.8) | 0 (0) | 3 (5.5) | 0.55 |
Appetite loss | 16 (20.2) | 6 (25) | 10 (18.2) | 0.55 |
Abdominal distension | 35 (44.3) | 8 (33.3) | 27 (49.1) | 0.23 |
Ascites | 8 (10.1) | 4 (16.7) | 4 (7.3) | 0.24 |
Infection of liver cysts | 23 (29.1) | 15 (62.5) | 8 (14.5) | <0.001 |
ECOG PS, n (%) | ||||
0/1/2/3/4 | 61 (77.2)/9 (11.4)/ 5 (6.3)/1 (1.3)/3 (3.8) | 15 (62.5)/4 (16.7)/2 (8.3)/ 1 (4.2)/2 (8.3) | 46 (83.6)/5 (9.1)/3 (5.5)/ 0 (0)/1 (1.8) | 0.13 |
Platelet count (×109/L) | 207 (166–275) | 243 (171–298) | 204 (166–242) | 0.12 |
PT (%) | 91.4 (78.3–101.0) | 83.9 (62.6–94.0) | 93.0 (82.0–101.0) | 0.021 |
Albumin (g/dL) | 3.8 (3.2–4.2) | 3.4 (2.3–3.9) | 3.9 (3.5–4.3) | 0.002 |
T-Bil (mg/dL) | 0.8 (0.7–1.2) | 0.9 (0.7–1.5) | 0.8 (0.7–1.1) | 0.33 |
ALT (IU/L) | 20 (15–37) | 35 (20–64) | 18 (12–23) | 0.002 |
Creatinine (mg/dL) | 0.7 (0.6–0.8) | 0.7 (0.5–1.0) | 0.7 (0.6–0.8) | 0.79 |
Minocycline Hydrochloride (n = 29) | Ethanolamine Oleate (n = 15) | Absolute Ethanol (n = 11) | p | |
---|---|---|---|---|
Age (years) | 70 (65–80) | 64 (60–73) | 69 (63–80) | 0.32 |
Male, n (%) | 4 (13.8) | 1 (6.7) | 4 (36.4) | 0.14 |
Complication with renal cysts, n (%) | 10 (34.5) | 8 (53.3) | 4 (36.4) | 0.47 |
Number of liver cysts, n (%) | ||||
<5 | 13 (44.8) | 5 (33.3) | 6 (54.5) | 0.83 |
5–10 | 7 (24.1) | 5 (33.3) | 3 (27.3) | |
>10 | 9 (31.0) | 5 (33.3) | 2 (18.2) | |
Maximum diameter of liver cysts (cm) | 13.1 (11.6–16.5) | 13.8 (10.8–19.2) | 12.0 (10.0–18.0) | 0.9 |
Symptoms, n (%) | ||||
Poor nutrition status with BMI < 18.5 kg/m2 | 2 (6.9) | 1 (6.7) | 0 (0) | 1 |
Appetite loss | 5 (17.2) | 2 (13.3) | 3 (27.3) | 0.72 |
Abdominal distension | 14 (48.3) | 8 (53.3) | 5 (45.5) | 1 |
Ascites | 3 (10.3) | 1 (6.7) | 0 (0) | 0.8 |
Infection of liver cysts | 6 (20.7) | 0 (0) | 2 (18.2) | 0.15 |
ECOG PS, n (%) | ||||
0/1/2/3/4 | 24 (82.8)/2 (6.9)/ 2 (6.9)/0 (0)/1 (3.4) | 13 (86.7)/2 (13.3)/ 0 (0)/0 (0)/0 (0) | 9 (81.8)/1 (9.1)/ 1 (9.1)/0 (0)/0 (0) | 0.92 |
Platelet count (×109/L) | 204 (166–229) | 196 (181–263) | 208 (158–238) | 0.91 |
PT (%) | 95.5 (78.7–107.5) | 93 (87.7–100.8) | 85.6 (80.5–99.4) | 0.72 |
Albumin (g/dL) | 4.0 (3.7–4.4) | 3.9 (3.5–4.2) | 3.7 (3.2–4.1) | 0.14 |
T-Bil (mg/dL) | 0.8 (0.7–1.0) | 0.7 (0.6–0.9) | 1.1 (0.8–1.4) | 0.1 |
ALT (IU/L) | 17 (12–21) | 18 (15–22) | 22 (14–43) | 0.29 |
Creatinine (mg/dL) | 0.7 (0.6–0.8) | 0.7 (0.6–0.8) | 0.7 (0.6–0.9) | 0.9 |
Univariate Analysis | Multivariate Analysis | ||||
---|---|---|---|---|---|
Recurrence (−) (n = 68) | Recurrence (+) (n = 11) | p | Odds Ratio (95% Confidence Interval) | p | |
Age (years) | 70 (64–79) | 80 (66–86) | 0.3 | ||
Male, n (%) | 16 (23.5) | 4 (36.4) | 0.46 | ||
Complication with renal cysts, n (%) | 30 (44.1) | 4 (36.4) | 0.75 | ||
Number of liver cysts, n (%) | |||||
<5 | 26 (38.2) | 6 (54.5) | 0.42 | ||
5–10 | 20 (29.4) | 1 (9.1) | |||
>10 | 22 (32.4) | 4 (36.4) | |||
Maximum diameter of liver cysts (cm) | 12.0 (9.8–16.0) | 19.7 (15.0–21.5) | 0.004 | 1.21 (1.06–1.38) | 0.005 |
Symptoms, n (%) | |||||
Poor nutrition status with BMI < 18.5 kg/m2 | 3 (4.4) | 0 (0) | 1 | ||
Appetite loss | 13 (19.1) | 3 (27.3) | 0.69 | ||
Abdominal distension | 29 (42.6) | 6 (54.5) | 0.52 | ||
Ascites | 8 (11.8) | 0 (0) | 0.59 | ||
Infection of liver cysts | 20 (29.4) | 3 (27.3) | 1 | ||
ECOG PS | 0 (0–0) | 0 (0–1) | 0.29 | ||
Treatment methods | |||||
Drainage alone | 21 (30.9) | 3 (27.3) | 0.57 | ||
Drainage and injection of absolute ethanol | 8 (11.8) | 3 (27.3) | |||
Drainage and injection of 5% ethanolamine oleate | 14 (20.6) | 1 (9.1) | |||
Drainage and injection of minocycline hydrochloride | 25 (36.8) | 4 (36.4) | |||
Platelet count (×109/L) | 208 (173–280) | 146 (134–234) | 0.099 | ||
PT (%) | 92.0 (81.0–101.0) | 85.6 (64.8–92.3) | 0.16 | ||
Albumin (g/dL) | 3.9 (3.4–4.2) | 3.0 (2.6–3.9) | 0.12 | ||
T-Bil (mg/dL) | 0.8 (0.6–1.2) | 1.0 (0.8–1.6) | 0.11 | ||
ALT (IU/L) | 19 (15–35) | 23 (14–54) | 0.44 | ||
Creatinine (mg/dL) | 0.7 (0.6–0.8) | 0.7 (0.5–0.9) | 0.42 |
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Takakusagi, S.; Kakizaki, S.; Saito, N.; Kohga, T.; Ueno, T.; Hatanaka, T.; Namikawa, M.; Tojima, H.; Naganuma, A.; Kosone, T.; et al. The Treatment Effects of Percutaneous Drainage with or without Sclerotherapy for Symptomatic Liver Cysts. Gastrointest. Disord. 2024, 6, 13-25. https://doi.org/10.3390/gidisord6010002
Takakusagi S, Kakizaki S, Saito N, Kohga T, Ueno T, Hatanaka T, Namikawa M, Tojima H, Naganuma A, Kosone T, et al. The Treatment Effects of Percutaneous Drainage with or without Sclerotherapy for Symptomatic Liver Cysts. Gastrointestinal Disorders. 2024; 6(1):13-25. https://doi.org/10.3390/gidisord6010002
Chicago/Turabian StyleTakakusagi, Satoshi, Satoru Kakizaki, Naoto Saito, Tatsuya Kohga, Takashi Ueno, Takeshi Hatanaka, Masashi Namikawa, Hiroki Tojima, Atsushi Naganuma, Takashi Kosone, and et al. 2024. "The Treatment Effects of Percutaneous Drainage with or without Sclerotherapy for Symptomatic Liver Cysts" Gastrointestinal Disorders 6, no. 1: 13-25. https://doi.org/10.3390/gidisord6010002