Abstract
Nine patients with 16 symptomatic nonneoplastic congenital hepatic cysts were treated prospectively by ultrasonically guided percutaneous minocycline hydrochloride injection, and the usefulness of this treatment was evaluated. Seven of the patients had multiple hepatic cysts, and two solitary cysts. All the patients were women, ranging in age from 36 to 81 years. After cystic fluid had been aspirated with a 21-gauge PTC needle, minocycline hydrochloride was injected into all the cysts. The minocycline hydrochloride was dissolved in saline at a concentration of 200 mg in 9 ml, and mixed with 1 ml of 2% mepivacaine hydrochloride. The total quantity of minocycline hydrochloride injected varied from 100 mg to 1200 mg per hepatic cyst, depending on its size. Total or subtotal regression of the cysts was observed in all patients during follow-up periods ranging from 15 to 35 months. Seven patients became symptom-free, one showed symptom reduction, and one showed no change in symptoms. Minor side effects, eg, transient abdominal pain, slight right shoulder pain, and temperature elevation, were noted in three patients respectively. On the basis of these results, we conclude that ultrasonically guided percutaneous minocycline hydrochloride injection is useful for the treatment of symptomatic hepatic cysts.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Hadad AR, Westbrook KC, Graham GG, Morris WD, Campbell GS: Symptomatic nonparasitic liver cysts. Am J Surg 134:739–744, 1977
Santman FW, Thijs LG, van der Veen EA, den Otter G, Blok P: Intermittent jaundice: A rare complication of a solitary nonparasitic liver cyst. Gastroenterology 72:325–328, 1977
Roemer CE, Ferrucci JT, Mueller PR, Simeone JF, van Sonnenberg E, Wittenberg J: Hepatic cysts: Diagnosis and therapy by sonographic needle aspiration. AJR 136:1065–1070, 1981
Cappell MS: Obstructive jaundice from benign, nonparasitic hepatic cysts: Identification of risk factors and percutaneous aspiration for diagnosis and treatment. Am J Gastroenterol 83:93–96, 1988
Saini S, Mueller PR, Ferrucci JT, Simeone JF, Wittenberg J, Butch RJ: Percutaneous aspiration of hepatic cysts does not provide definitive therapy. AJR 141:559–560, 1983
Jones WL, Mountain JC, Warren KW: Symptomatic nonparasitic cysts of the liver. Br J Surg 61:118–123, 1974
Rashed A, May RE, Williamson RC: The management of large congenital liver cysts. Postgrad Med J 58:536–541, 1982
Litwin DEM, Taylor BR, Greig P, Langer B: Nonparasitic cysts of the liver. The case for conservative surgical management. Ann Surg 205:45–48, 1987
Newman K, Torres VE, Rakela J, Nagorney DM: Treatment of highly symptomatic polycystic liver disease. Preliminary experience with a combined hepatic resection-fenestration procedure. Ann Surg 212:30–37, 1990
Sanchez H, Gagner M, Rossi RL, Jenkins RL, Lewis WD, Munson JL, Braasch JW: Surgical management of nonparasitic cystic liver disease. Am J Surg 161:113–119, 1991
Bruns DH, Klomp HJ, Kremer B: Non-parasitic liver cysts and polycystic liver disease: Results of surgical treatment. Hepato-Gastroenterol 40:1–5, 1993
Bean WJ, Rodan BA: Hepatic cysts: Treatment with alcohol. AJR 144:237–241, 1985
Trinkl W, Sassaris M, Hunter FM. Nonsurgical treatment for symptomatic nonparasitic liver cyst. Am J Gastroenterol 80:907–911, 1985
Andersson R, Jeppsson B, Lunderquist A, Bengmark S: Alcohol sclerotherapy of nonparasitic cysts of the liver. Br J Surg 76:254–255, 1989
Kairaluoma M, Leinonen A, Stahlberg M, Paivansalo M, Kiviniemi H, Siniluoto T: Percutaneous aspiration and alcohol sclerotherapy for symptomatic hepatic cysts. An alternative to surgical intervention. Ann Surg 210:208–215, 1989
Rosenberg G: Solitary non-parasitic cysts of liver. Am J Surg 91:441–444, 1956
Goldstein H, Carlyle DR, Nelson R: Treatment of symptomatic cyst by percutaneous instillation of pantopaque. AJR 127:850–852, 1976
Rubinson RM, Bolooki H: Intrapleural tetracycline for control of malignant pleural effusion: A preliminary report. South Med J 65:847–849, 1972
Bodker A, Sommer W, Andesen JT, Kristensen JK: Treatment of hydrocele of the testis with aspiration and injection of tetracycline. Br J Urol 57:192–193, 1985
Okasho A, Yamamoto H, Asari T, Saitoh Y, Kosaka S, Shimamura M, Miyagi T, Sawaki M, Shoda R, Koizumi H, Ohkawa M: A new treatment for simple renal cyst: Percutaneous instillation of minocycline hydrochloride into simple renal cyst. Acta Urol Jpn 33:1162–1166, 1987 (in Japanese)
Shigeyasu T, Kanamori T, Ide M, Hirose A, Oono T, Nagahara K, Tsukada K, Ito W, Takeuchi T: Treatment with minocycrine for solitary hepatic cyst. Kan Tan Sui 17:1027–1031, 1988 (in Japanese)
Ito H, Setoguchi Y, Yamamoto K, Kariya T, Sakai T: A cured case of polycystic liver by injection of minocycline hydrochloride. Kan Tan Sui 17:1053–1058, 1988 (in Japanese)
Oomoto K, Yamamoto S, Ideguchi S, Yamamoto R, Takatori K, Ohumi T, Hino K, Hirano Y, Hirokawa M: Treatment for hepatic cyst by injection of minocycline hydrochloride. Nippon Shoukakibyo Gakkai Zasshi 87:273–277, 1990 (in Japanese)
Fisher J, Mekhjian H, Pritchett ELC, Charme LS: Polycystic liver disease: Studies on the mechanisms of cyst fluid formation. Gastroenterology 66:423–428, 1974
Everson GT, Emmett M, Brown WR, Redmond P, Thickman D: Functional similarities of hepatic cystic and in vivo secretion in response to secretin. Hepatology 11:557–565, 1990
Iwase K, Takenaka H, Oshima S, Yagura A, Nishimura Y, Yoshidome K, Tanaka T: Determination of tumor marker levels in cystic fluid of benign liver cysts. Dig Dis Sci 37:1648–1654, 1992
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Yamada, N., Shinzawa, H., Ukai, K. et al. Treatment of symptomatic hepatic cysts by percutaneous instillation of minocycline hydrochloride. Digest Dis Sci 39, 2503–2509 (1994). https://doi.org/10.1007/BF02087673
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02087673