摘要
AIM: To evaluate the factors that influence outcome of both non-invasive and invasive treatment of polycystic liver disease. METHODS: Analysis of clinical files of patients with complete follow-up from July 1986 to June 2006. RESULTS: Forty-one patients (male, 7; female, 34), 47.8 ± 11.9 years age, and 5.7 ± 6.7 years follow-up, were studied. Alkaline phosphatase (AP) elevation (15% of patients) was associated with the requirement of invasive treatment (IT, P = 0.005). IT rate was higher in symptomatic than non-symptomatic patients (65.4% vs 14.3%, P = 0.002), and in women taking hormonal replacement therapy (HRT) (P = 0.001). Cysts complications (CC) were more frequent (22%) in the symptomatic patients group (P = 0.023). Patients with body mass index (BMI) > 25 (59%) had a trend to complications after IT (P = 0.075). Abdominal pain was the most common symptom (56%) and indication for IT (78%). Nineteen patients (46%) required a first IT: 12 open fenestration (OF), 4 laparoscopic fenestration (LF) and 3 fenestration with hepatic resection (FHR). Three required a second IT, and one required a third procedure. Complications due to first IT were found in 32% (OF 16.7%, LF 25%, FHR 66.7%), and in thesecond IT in 66.7% (OF 100%). Follow-up mortality rate was 0. CONCLUSION: Presence of symptoms, elevated AP, and CC are associated with IT requirement. HRT is associated with presence of symptoms and IT requirement. Patients with BMI > 25 have a trend be susceptible to IT complications. The proportions of complications are higher in FHR and second IT groups. RS is more frequent after OF.
AIM： To evaluate the factors that influence outcome of both non-invasive and invasive treatment of polycystic liver disease. METHODS： Analysis of clinical files of patients with complete follow-up from July 1986 to June 2006. RESULTS： Forty-one patients （male, 7; female, 34）, 47.8 ＋ 11.9 years age, and 5.7 ＋ 6.7 years follow-up, were studied. Alkaline phosphatase （AP） elevation （15% of patients） was associated with the requirement of invasive treatment （IT, P = 0.005）. IT rate was higher in symptomatic than non-symptomatic patients （65.4% vs 14.3%, P = 0.002）, and in women taking hormonal replacement therapy （HRT） （P = 0.001）. Cysts complications （CC） were more frequent （22%） in the symptomatic patients group （P = 0.023）. Patients with body mass index （BMI） 〉 25 （59%） had a trend to complications after IT （P = 0.075）. Abdominal pain was the most common symptom （56%） and indication for IT （78%）. Nineteen patients （46%） required a first IT： 12 open fenestration （OF）, 4 laparoscopic fenestration （LF） and 3 fenestration with hepatic resection （FHR）. Three required a second IT, and one required a third procedure. Complications due to first IT were found in 32% （OF 16.7%, LF 25%, FHR 66.7%）, and in the second IT in 66.7% （OF 100%）. Follow-up mortality rate was 0. CONCLUSION： Presence of symptoms, elevated AP, and CC are associated with IT requirement. HRT is associated with presence of symptoms and IT requirement. Patients with BMI 〉 25 have a trend be susceptible to IT complications. The proportions of complications are higher in FHR and second IT groups. RS is more frequent after OF.
基金
the "Secretaría de Relaciones Exteriores (SRE)" of the Government of Mexico
关键词
肝脏手术
开窗术
治疗方法
临床表现
Hepatic cysts
Open fenestration
Laparoscopic fenestration
Hepatic resection
Recurrenceof symptoms
Hormonal replacement therapy
