Poster Session : PS 0946 ; Liver : Ethanol Lavage of Huge Hepatic Cysts Using Endoscopic Ultrasound Guidance and a Percutaneous Approach = Poster Session : PS 0946 ; Liver : Ethanol Lavage of Huge Hepatic Cysts Using Endoscopic Ultrasound Guidance and a Percutaneous Approach

다국어 초록 (Multilingual Abstract)

The aim of this study was to evaluate the utility of endoscopic ultrasound (EUS) guidance and percutaneous ethanol lavage for the treatment of symptomatic large benign liver cysts. Here, we describe patients with large, liver cysts who experienced complete resolution following cyst drainage and alcohol ablation. From April 2009 to October 2012, 17 patients with 19 hepatic cysts were enrolled. Patients underwent ethanol lavage via percutaneous and/or EUS-guided approaches. Residual cysts were monitoredby computed tomography. The median cyst volume before therapy was 368.9 ml (interquartile range, 195.3-795.9 ml). Ten cysts were drained by the percutaneous approach with a pigtail catheter and eight cysts underwent EUS-guided aspiration and lavage treatment. In one case, both the percutaneous approach and EUS-guided puncture was used due to septation with calcifi cations within the cyst. During the median 11.5-month follow-up (interquartile range, 7.8-22.6 months) of the percutaneous approach group, the cysts showed 97.5% reduction. During the median 15-month follow-up (interquartile range, 9.8-19.9 months) of the EUS-guided group, the cysts showed nearly 100% reduction. Percutaneous catheter drainage ethanol lavage was more feasible for right-sided, larger cysts, whereas the EUS-guided approach was useful for left lobe cysts. EUS-guided ethanol lavage could also be performed in a onestep approach without the hassles of catheter insertion, with repeated aspiration for polycystic diseases possible. Conclusion: Excellent symptomatic and radiological responses and long-term results were achieved with percutaneous catheter drainage and EUS-guided ethanol lavage. EUS-guided hepatic cyst lavage could be considered as a primary method of treatment with a high degree of technical feasibility and safety. Careful patient selection and tailored approaches for large, symptomatic hepatic cysts may signifi cantly improve outcomes.