Single-session alcohol sclerotherapy of symptomatic liver cysts using 10–20 min of ethanol exposure: no recurrence at 2–16 years of follow-up

Abstract

Purpose: To assess long-term results after single-session alcohol sclerotherapy of symptomatic benign liver cysts performed with maximum 20 min of exposure to alcohol. Methods: We included 47 patients aged 32–88 years (42 women, 5 men) with 51 benign non-parasitic liver cysts that were exposed to ethanol for 7–20 min in a single sclerotherapy session and were followed for at least 24 months. Each cyst was emptied before injecting ethanol (10% of cyst volume, but maximum 100 mL) into it. The patient rotated from side to side to facilitate contact between ethanol and the whole cyst wall. Pre-treatment cyst volume was defined as the volume of aspirated cyst fluid after complete emptying of the cyst. Follow-up cyst volume was estimated based on computed tomography images. Results: Cyst volumes were 30–4900 (median 520) mL at pre-treatment and 0–230 (median 1) mL at 24–193 (median 56) months follow-up, a reduction of 83–100% (median 99.7%). No cyst required repeated treatment during the follow-up. Median volume reduction was 99.7% at median 49 months of follow-up for 35 cysts exposed to ethanol for 7–10 min vs. 99.6% at median 75 months of follow-up for 16 cysts exposed for 20 min (p = 0.83, Mann–Whitney test). Ethanol intoxication occurred in one patient. There were no other complications except for pain. Conclusion: Long-term results of single-session alcohol sclerotherapy performed with maximum 20 min of exposure to ethanol were satisfactory with no sign of recurrence of cyst fluid.