Results of laparoscopic deroofing with chemical ablation by ethanol dispersal for symptomatic liver cyst

Abstract

Introduction: For treatment of symptomatic liver cyst, deroofing of the cystic wall is most commonly performed treatment. However, reaccumulation of fluid is a problem. We introduced ethanol dispersal combined with laparoscopic deroofing to reduce the risk of reaccumlation. We report the short- and long-term results of laparoscopic deroofing with ethanol dispersal. Methods: Between 2011 and 2017, eight patients underwent laparoscopic deroofing and ethanol dispersal (ethanol group), and eight patients underwent only laparoscopic deroofing (former period; historical control). In deroofing and ethanol dispersal, 100-ml of absolute ethanol was sprayed on the internal surface of cyst after fenestration of cyst. Short- and long-term results were evaluated and compared the two groups. Results: The medial operative time and postoperative hospital stay were 138 minutes and 130 minutes, 4 days and 4.5 days, in ethanol group and in control group respectively. The serum AST levels in ethanol group showed mild elevation as 50.5IU/L and were 28IU/L in control group (p=0.066). But the AST level in ethanol group normalized a month after surgery (median, 21.5 IU/L). The medial size of cyst before surgery was 16.5cm in ethanol group, and 17 cm in control group (p=0.920). The medial size 9 to 12 months after surgery was 3 cm in ethanol group and 8.5cm in control group, which showed significant difference (p=0.046). Conclusion: Laparoscopic deroofing and chemical ablation by ethanol dispersal for symptomatic liver cyst is safe and useful to prevent reaccumulation of the liver cyst.