[The echo-guided percutaneous treatment of dysontogenetic cysts of the liver]

Congenital cystic disease of the liver include two different entities, in the last years more frequently and easily recognized by ultrasonography or computed tomography: the simple, nonparasitic or biliary or solitary cysts of the liver and the polycystic liver disease. Our experience concern 153 patients affected by nonparasitic hepatic cysts and 17 patients affected by polycystic liver disease. 10/153 patients (6.5%) with symptomatic simple cysts have been treated by percutaneous US-guided aspiration and intracystic instillation of ethanol. All the patients were discharged asymptomatic after 24 hours with no complications; only in 2 patients a second treatment was necessary. Repeated follow-up examination showed non recurrence. The same procedure was also used for 3/17 symptomatic patients affected by polycystic liver disease in order to give temporary relief of the symptoms due to compression (pain, dyspnea, vomit, jaundice). A 45-years-old lady, with previous several surgical fenestrations, was treated for 10 years by 20 sessions of percutaneous aspiration and instillation of ethanol with no complications. We conclude that the percutaneous aspiration and intracystic instillation of ethanol would be recommended as primary treatment of patients affected by non parasitic cysts of the liver, because it offers good relief of the symptoms due to compression with good patients compliance and without complications.