scholarly journals Polyhedral Fenestration Technique Used for Combined Partial Hepatectomy and Cyst Fenestration for Polycystic Liver Disease: A Small Case Series

2020 ◽  
Vol 104 (3-4) ◽  
pp. 159-165
Author(s):  
Yoshiki Sato ◽  
Daisuke Morioka ◽  
Kazuya Yamaguchi ◽  
Nobutoshi Horii ◽  
Kentaro Miyake ◽  
...  
Keyword(s):  
Liver Disease ◽  
Case Series ◽  
Patient Characteristics ◽  
Control Group ◽  
Polycystic Liver Disease ◽  
Long Term Outcomes ◽  
Ct Volumetry ◽  
Polycystic Liver ◽  
Cyst Fenestration

Objective: To assess the safety and efficacy of “polyhedral fenestration technique” (PFT), which we newly developed, in combined hepatectomy and cyst fenestration (CHCF) for symptomatic polycystic liver disease (PLD). Summary of background data: CHCF for PLD has been reportedly less efficacious for its invasiveness because 50% to 70% patients suffered recurrent symptoms after CHCF. Methods: Patient characteristics, intra- and early postoperative variables were compared between 5 PLD patients undergoing CHCF performed with PFT (PLD group) and 95 patients with diseases other than PLD receiving hepatectomy without biliary reconstruction during the same period (Control group) to assess safety of PFT. Chronological changes in total liver volume (TLV) measured by computed tomography (CT) volumetry as well as recurrent symptoms after CHCF were investigated to assess long-term outcomes. Results: Although ≧ Clavien-Dindo grade 2 complications were more common in the PLD group than in the Control group (PLD vs Control, 5/5[100%] vs 27/95[28%], p=0.004), patient characteristics, intra-, and early postoperative variables, including ≧ Clavien-Dindo grade 3 complications, were comparable among the 2 groups. Postoperative observational period of the 5 PLD patients ranged 30 to 88 months with a median of 63. CT volumetry revealed that TLV continued to reduce up to 1 year after surgery and thereafter retained less than 0.5 times of preoperative TLV in all patients. Recurrent liver enlargement or recurrent symptoms were not observed in any of the 5 PLD patients. Conclusions: Although our case series was very small, newly-developed PFT in CHCF for PLD yielded acceptable safety and excellent long-term outcomes.

scholarly journals Peri‐operative challenges and long‐term outcomes in liver transplantation for polycystic liver disease

HPB ◽  
2013 ◽  
Vol 15 (4) ◽  
pp. 302-306 ◽  
Author(s):  
Roberto Gedaly ◽  
Paige Guidry ◽  
Daniel Davenport ◽  
Michael Daily ◽  
Jens Ronsenau ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Disease ◽  
Polycystic Liver Disease ◽  
Long Term Outcomes ◽  
Polycystic Liver

scholarly journals Treatment of polycystic liver disease: a hypothesis, patient characteristics, short and long-term results

2013 ◽  
Vol 12 (5) ◽  
pp. 782-790
Author(s):  
Zheng Long-Xian ◽  
Liu Ai-Wu ◽  
Qin Hua-Dong ◽  
Cui Jun ◽  
Jiang Hui-Jie ◽  
...  
Keyword(s):  
Liver Disease ◽  
Patient Characteristics ◽  
Long Term Results ◽  
Polycystic Liver Disease ◽  
Polycystic Liver ◽  
Short And Long Term

scholarly journals Efficacy and safety of selective decontamination of the digestive tract (SDD) to prevent recurrent hepatic cyst infections in polycystic liver disease: a retrospective case series

2020 ◽  
Vol 75 (9) ◽  
pp. 2666-2669
Author(s):  
Lucas H P Bernts ◽  
Shosha E I Dekker ◽  
Darius Soonawala ◽  
Roger J M Brüggemann ◽  
Heiman F L Wertheim ◽  
...  
Keyword(s):  
Liver Disease ◽  
Adverse Events ◽  
Digestive Tract ◽  
Case Series ◽  
Hepatic Cyst ◽  
Selective Decontamination ◽  
Polycystic Liver Disease ◽  
Polycystic Liver ◽  
Cyst Infection ◽  
Polymyxin E

Abstract Background Hepatic cyst infection is a complication of polycystic liver disease (PLD) that causes substantial morbidity. Repetitive infection is frequent and is increasingly difficult to treat. As translocated gut bacteria are considered the cause, we hypothesize that selective decontamination of the digestive tract (SDD) reduces recurrence of hepatic cyst infection. Methods We performed a retrospective, observational study in two referral centres. All patients with PLD treated with SDD for hepatic cyst infection were included. Efficacy was determined by calculating the infection incidence (hepatic cyst infections per month) before and during SDD therapy. Adverse events were scored according to the Common Terminology Criteria for Adverse Events (CTCAE). Results We identified eight patients who received SDD (88% female, 88% polycystic kidney disease). The median age was 65 years (IQR: 51–74 years). SDD lowered the median incidence from 0.09 episodes per month (IQR: 0.06–0.25 episodes per month) to 0.01 episodes per month (IQR: 0.00–0.05 episodes per month) (P = 0.12). Discontinuation of SDD led to rapid recurrence of cyst infection (71% within 6 weeks). SDD consisted of polymyxins with/without aminoglycosides. The median SDD treatment duration was 20 months (range: 3–89 months). Six patients (75%) developed adverse events [CTCAE Grade 1 (gastrointestinal: n = 3) or Grade 3 (ototoxicity: n = 1; fungal infection: n = 1)], mostly attributable to aminoglycosides; one patient developed polymyxin E resistance. Conclusions SDD prophylaxis provides a novel strategy for limiting recurrent hepatic cyst infection in PLD patients. However, adverse events are frequent and curtail its use. As most were attributable to aminoglycosides, polymyxin E is considered the preferred therapy.

Efficacy of Percutaneous US-Guided Polidocanol Sclerotherapy: Long-Term Follow-up of 100 Patients with Polycystic Liver Disease

2011 ◽  
Vol 37 (8) ◽  
pp. S136
Author(s):  
A. Potthoff ◽  
F. Sandkühler ◽  
B. Boozari ◽  
M.P. Manns ◽  
M.J. Gebel ◽  
...  
Keyword(s):  
Liver Disease ◽  
Polycystic Liver Disease ◽  
Polycystic Liver ◽  
Long Term Follow Up

scholarly journals Long-Term Outcomes in Children with Acute Flaccid Myelitis

2021 ◽  
Author(s):  
Megan Henley ◽  
Lindie Hill ◽  
Sydney Inman ◽  
Molly King ◽  
Sam Lopez ◽  
...  
Keyword(s):  
Case Series ◽  
Rehabilitation Program ◽  
Fine Motor ◽  
Control Group ◽  
Long Term Outcomes ◽  
Functional Deficits ◽  
Acute Flaccid Myelitis ◽  
Group A ◽  
Study Designs

The purpose of our critically appraised topic is to combine the best evidence regarding the long-term outcomes in children with acute flaccid myelitis (AFM) regarding posture and movement, gross and fine motor control, and activities of daily living (ADL) performance. The final portfolio contains eight articles. The study designs of these articles include a retrospective cohort study, two retrospective non-randomized studies without a control group, a retrospective review, a nationwide follow-up questionnaire analysis study, a case report, a case series, and a multiple quantitative case study. All studies related directly to our evidence-based PICO question and were used to determine the best evidence of the long-term outcomes in children with AFM. Overall, our findings showed that functional improvements were seen in most i ndividuals, however, this varied from complete to incomplete recovery along with some persistent motor and functional deficits. Every case is different depending on when they were diagnosed, and how quickly they were able to implement a rehabilitation program into their everyday routine.

Monoethanolamine Oleate Sclerotherapy for Polycystic Liver Disease

2016 ◽  
Vol 34 (6) ◽  
pp. 654-658 ◽  
Author(s):  
Masahiro Takita ◽  
Mina Iwanishi ◽  
Tomohiro Minami ◽  
Masashi Kono ◽  
Hirokazo Chishina ◽  
...  
Keyword(s):  
Liver Disease ◽  
Infusion Therapy ◽  
Polycystic Liver Disease ◽  
Disease Group ◽  
Simple Cyst ◽  
Liver Cysts ◽  
Polycystic Liver ◽  
Long Term Follow Up

Objective: The objective of treatment for polycystic liver disease is to reduce the liver volume and reduce or resolve compression symptoms such as abdominal fullness and abdominal pain due to hepatomegaly. Liver cysts are treated internally by puncture and aspiration of the cyst contents or hepatic artery embolization and surgically by cyst fenestration or hepatectomy, but no clear consensus has been reached concerning their selection. We introduced monoethanolamine oleate (EO) sclerotherapy therapy for liver cysts in 1999 and reported its effectiveness. In this study, cases were added, and the results including those of long-term follow-up were evaluated. Subjects: Twenty-two patients (5 males and 17 females, mean age 65.2) who underwent EO infusion therapy for liver cysts between January 1999 and June 2011 were evaluated. Methods: Liver cysts were punctured under ultrasound guidance, and a 7Fr pigtail catheter was inserted. After aspirating the cyst contents, EO was infused, and a clamp was applied for 24 h. Then, the catheter was declamped, cyst contents were aspirated again, and the catheter was removed. After the treatment, the cyst size was measured, and the patients were followed up. Results: Eight simple cysts in 8 patients (simple cyst group) and 21 cysts in 14 patients with multiple cysts (polycystic liver disease group) were treated and followed up over a median of 78 months (0-203 months). The mean volume reduction rate was 99% in the simple cyst group and 91% in the polycystic liver disease group (p = 0.04). One procedural accident resulting in liver abscess formation was observed in 1 patient 1 week after discharge, and it required drain placement and antibiotic administration. While mild abdominal pain was observed in a few patients, it was resolved spontaneously under observation. Conclusion: EO infusion therapy achieves fairly high treatment response in the volume reduction (99%) and sustained shrinkage over long-term follow-up. Therefore, this is a breakthrough technique in the treatment of polycystic liver disease as well as simple cyst and should be a standard of care in the treatment of this disease.

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