[Sclerotherapy of single non-parasitic liver cyst]

Single, non-parasitic liver cysts, usually asymptomatic, accidental finding during ultrasound examination require treatment only if they attain larger diameter and upper right quadrant symptoms could not be explained by other pathology. Treatment options include surgical enucleation, open or laparoscopic unroofing or percutaneous emptying usually associated with injection of sclerotising agent. From May 1995 to June 1997 10 patients with single, symptomatic, non-parasitic cysts of the liver were treated at the 2nd Department of General Surgery, Collegium Medicum of Jagiellonian University. Ultrasound and gastroscopy excluded other pathology of upper GI tract that might be responsible for the symptoms. Under ultrasound guidance samples of cysts content were collected for cytology, bilirubin concentration and bacteriology. Injection of the contrast medium revealed no contact of the cyst's cavity with the biliary tree. 5 patients were excluded from the protocol due to leakage of contrast in to fee peritoneal cavity. Other 5 were submitted to sclerotherapy by injection of 95% ethanol after introduction of fine drain into the cyst's cavity under ultrasound guidance; in two patients procedure was performed once, in two twice and in one tree times. In 4 patients complete or nearly complete resolution of symptoms was achieved, in one with big cyst treatment failed. We observed no complication. Owing to satisfying results we may conclude that this minimally invasive method might be attempted before more aggressive treatment would be employed.