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Fenestration of liver cysts in polycystic liver disease to improve quality of life: a case report and literature review.

Jung DH, Hwang S, Ahn CS, Moon DB, Song GW, Kim KH, Ha TY, Park GC, Lee SG - Korean J Hepatobiliary Pancreat Surg (2015)

Bottom Line: Multiple cysts in the enlarged liver were opened and the cyst walls were excised with electrocautery.The total liver volume was 3,870 ml before surgery and 3,125 ml at 1 week after surgery, showing a volume reduction of 19.3%.After surgery, her performance status improved significantly.

View Article: PubMed Central - PubMed

Affiliation: Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

ABSTRACT
Polycystic liver disease (PCLD) is characterized by a large number of liver cysts scattered throughout the liver parenchyma. We herein intend to present the beneficial effect of palliative fenestration treatment on quality of life in a patient with symptomatic PCLD. A 48-year-old female patient had been followed up for 5 years for both polycystic liver and kidney diseases at another institution. During follow-up for last 1 year, we recognized that she had barely maintained her ability of function in daily activities due to progressive worsening of fatigue and dyspnea on exertion. The patient finally underwent surgical fenestration treatment. Multiple cysts in the enlarged liver were opened and the cyst walls were excised with electrocautery. No surgical complication occurred and the patient was discharged 10 days after the open fenestration surgery. The total liver volume was 3,870 ml before surgery and 3,125 ml at 1 week after surgery, showing a volume reduction of 19.3%. After surgery, her performance status improved significantly. In the present case, significant improvement in quality of life and daily activity performance was achieved after open fenestration treatment over 18 months of follow-up without disease recurrence.

No MeSH data available.


Related in: MedlinePlus

Operative findings of a 52-year-old female patient undergoing liver transplantation with a MELD score of 18. Markedly enlarged liver was bulged out of the abdomen (A); There were numerous liver cysts that occupied the majority of liver parenchyma (B); Rupture of the liver cysts led to reduction of the liver volume (C), which facilitated handling of the native liver for liver transplantation (D).
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Figure 6: Operative findings of a 52-year-old female patient undergoing liver transplantation with a MELD score of 18. Markedly enlarged liver was bulged out of the abdomen (A); There were numerous liver cysts that occupied the majority of liver parenchyma (B); Rupture of the liver cysts led to reduction of the liver volume (C), which facilitated handling of the native liver for liver transplantation (D).

Mentions: Orthotopic liver transplantation is the only curative treatment for patients with severe PCLD.19 It is indicated in those patients with disabling symptoms that lead to decreased performance status and quality of life. Patients with PCLD usually have normal liver function and the organ allocation system based on the Model for End-Stage Liver Disease (MELD) or Korean Network for Organ Sharing (KONOS) is often unable to assist this group of patients. For these patients, MELD exception criteria seem to be necessary.2021 Because of the shortage of available grafts, the need for life-long immunosuppression, and the perioperative risks, liver transplantation is indicated only in symptomatic patients (Fig. 6). In the current Korean setting in which the majority of deceased donor liver grafts are allocated to urgent patients, most patients with PCLD have a very low chance of receiving deceased donor liver grafts; therefore, some of them have undergone living donor liver transplantation.2223


Fenestration of liver cysts in polycystic liver disease to improve quality of life: a case report and literature review.

Jung DH, Hwang S, Ahn CS, Moon DB, Song GW, Kim KH, Ha TY, Park GC, Lee SG - Korean J Hepatobiliary Pancreat Surg (2015)

Operative findings of a 52-year-old female patient undergoing liver transplantation with a MELD score of 18. Markedly enlarged liver was bulged out of the abdomen (A); There were numerous liver cysts that occupied the majority of liver parenchyma (B); Rupture of the liver cysts led to reduction of the liver volume (C), which facilitated handling of the native liver for liver transplantation (D).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4494095&req=5

Figure 6: Operative findings of a 52-year-old female patient undergoing liver transplantation with a MELD score of 18. Markedly enlarged liver was bulged out of the abdomen (A); There were numerous liver cysts that occupied the majority of liver parenchyma (B); Rupture of the liver cysts led to reduction of the liver volume (C), which facilitated handling of the native liver for liver transplantation (D).
Mentions: Orthotopic liver transplantation is the only curative treatment for patients with severe PCLD.19 It is indicated in those patients with disabling symptoms that lead to decreased performance status and quality of life. Patients with PCLD usually have normal liver function and the organ allocation system based on the Model for End-Stage Liver Disease (MELD) or Korean Network for Organ Sharing (KONOS) is often unable to assist this group of patients. For these patients, MELD exception criteria seem to be necessary.2021 Because of the shortage of available grafts, the need for life-long immunosuppression, and the perioperative risks, liver transplantation is indicated only in symptomatic patients (Fig. 6). In the current Korean setting in which the majority of deceased donor liver grafts are allocated to urgent patients, most patients with PCLD have a very low chance of receiving deceased donor liver grafts; therefore, some of them have undergone living donor liver transplantation.2223

Bottom Line: Multiple cysts in the enlarged liver were opened and the cyst walls were excised with electrocautery.The total liver volume was 3,870 ml before surgery and 3,125 ml at 1 week after surgery, showing a volume reduction of 19.3%.After surgery, her performance status improved significantly.

View Article: PubMed Central - PubMed

Affiliation: Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

ABSTRACT
Polycystic liver disease (PCLD) is characterized by a large number of liver cysts scattered throughout the liver parenchyma. We herein intend to present the beneficial effect of palliative fenestration treatment on quality of life in a patient with symptomatic PCLD. A 48-year-old female patient had been followed up for 5 years for both polycystic liver and kidney diseases at another institution. During follow-up for last 1 year, we recognized that she had barely maintained her ability of function in daily activities due to progressive worsening of fatigue and dyspnea on exertion. The patient finally underwent surgical fenestration treatment. Multiple cysts in the enlarged liver were opened and the cyst walls were excised with electrocautery. No surgical complication occurred and the patient was discharged 10 days after the open fenestration surgery. The total liver volume was 3,870 ml before surgery and 3,125 ml at 1 week after surgery, showing a volume reduction of 19.3%. After surgery, her performance status improved significantly. In the present case, significant improvement in quality of life and daily activity performance was achieved after open fenestration treatment over 18 months of follow-up without disease recurrence.

No MeSH data available.


Related in: MedlinePlus