超声引导经皮穿刺治疗乳腺脓肿的临床应用

目的评价超声引导下经皮穿刺治疗乳腺脓肿的临床应用价值。方法在超声引导下,对诊断为乳腺脓肿的病人采用经皮穿刺脓肿抽吸法及脓腔置管引流法进行治疗。结果 45例病人共有54个脓肿,22个最大径≤3 cm的脓肿采用脓肿抽吸法治愈21例,1例改行脓腔置管引流后治愈;32个最大径>3 cm的脓肿实施脓腔置管引流法,治愈30例,切开引流2例。随访41例,复发4例,2例再次行脓腔置管引流治愈,另2例行脓肿切开引流治愈。结论超声引导下穿刺抽吸治疗不超过3 cm的乳腺脓肿与置管引流治疗超过3 cm的乳腺脓肿均是有效的治疗手段。     

Percutaneous drainage of pyogenic liver abscesses

This report summarizes the results of percutaneous catheter drainage in 23 cases of primary or secondary pyogenic liver abscess. The overall success rate was 76%. Only three (60%) of five cases of secondary abscess (infected hematoma or infected tumor) were cured with catheter drainage, but 11 (91%) of the last 12 primary pyogenic abscesses were drained successfully. Six patients with abscesses of less than 4 cm in diameter required catheter drainage for less than 72 hr. Although six abscesses in the series appeared septated or multiloculated, only one required more than a single catheter for curative drainage. Diagnostic and technical considerations for successful drainage of hepatic abscesses are discussed. The differential diagnosis includes echinococcal disease and hepatic amebiasis. Therapeutically, specific measures should be taken to ensure proper catheter position to prevent contamination of the subphrenic, perihepatic, and pleural spaces. Percutaneous catheter drainage should be attempted as a first choice of treatment in all pyogenic hepatic abscesses.     

A new interventional technique for percutaneous treatment of drainage-resistant liver abscess

The objective of this case report is to describe a device that can be used as a minimally invasive alternative for the treatment of drainage-resistant liver abscess. The device uses pulse lavage to fragment and evacuate the semi-solid contents of a liver abscess. The treatment of liver abscesses consists of percutaneous drainage, antibiotics and treatment of the underlying cause. This approach can be ineffective if the contents of the abscess cavity are not liquid, and in those cases open surgery is often needed. Here, we describe for the first time a new minimally invasive technique for treating persistent liver abscesses. A patient developed a liver abscess after a hepatico-jejunostomy performed as a palliative treatment for an unresectable pancreatic head carcinoma. Simple drainage by a percutaneously placed pig-tail catheter was insufficient because of inadequate removal of the contents of the abscess cavity. After dilatation of the drain tract the persistent semi-solid necrotic contents were fragmented by a pulsed lavage device, after which the abscess healed uneventfully. The application of pulsed lavage for debridement of drainage-resistant liver abscesses proved to be an effective and minimally invasive alternative to open surgery.The mainstays of the treatment of liver abscesses are drainage and antibiotics. Drainage can be performed by ultrasound- or CT-guided percutaneous drain placement or by surgical techniques using laparoscopy or laparotomy. The most appropriate method of drainage is controversial and varies from open surgery to repeated percutaneous punctures. Surgical drainage had a higher success rate and a shorter hospital stay than percutaneous drainage in a retrospective study of 80 patients with large pyogenic liver abscesses [1]. By contrast, a randomised trial revealed that drainage by repeated puncture was equally as effective as percutaneous drainage in which an indwelling catheter was left behind [2]. For most patients with liver abscesses, percutaneous drainage is an effective treatment.In patients with highly viscid, sticky pus or infected necrotic tissue, it is much more difficult to clean the abscess cavity because of occlusion of the relatively narrow percutaneous drain and inability to remove the semi-solid contents. In these cases, surgery is performed to create a large opening and adequate drainage of the contents of the abscess cavity. Even partial liver resection has been advocated for the treatment of drainage-resistant liver abscesses [3].Here, we describe a new technique that has the potential to treat a non-resolving liver abscess efficiently after simple percutaneous drainage. The technique uses pulsed lavage, which is able to fragment and evacuate non-liquefied debris in a liver abscess using a percutaneous approach.     

超声引导下经皮穿刺抽吸或置管治疗细菌性肝脓肿疗效比较

目的 比较超声引导下穿刺抽吸或置管引流对细菌性肝脓肿的疗效。方法 回顾性分析我院1994-01至2013-01收治的经超声引导下穿刺抽吸或置管引流的细菌性肝脓肿96例,分别比较两组患者之间的治疗成功率、并发症率、病死率及住院时间。结果 分别有42例及54例行穿刺抽吸及置管引流治疗,两组间并发症率（4.8%vs 5.6%,P=1.00）、病死率（2.3%vs 1.9%,P=1.00）及住院时间[（19.1±12.1）d vs（21.6±12.5）d,P=0.44]差异无统计学意义。置管引流组治疗成功率显著高于抽吸组（61.9%vs 92.6%,P=0.00）,但对于脓腔直径≤6 cm者,治疗成功率无明显区别（91.0%vs 96.7%,P=0.57）。结论 超声引导下经皮穿刺置管引流治疗肝脓肿优于穿刺抽吸,对于直径≤6 cm者,穿刺抽吸是可选择的替代手段。     

Percutaneous treatment of pyogenic liver abscess: A critical analysis of results

Nineteen patients who had pyogenic liver abscesses underwent percutaneous treatment assisted by computed tomography. Percutaneous drainage was performed with Fr 8-14 catheters in 12 patients and percutaneous aspiration in 7 patients. A solitary abscess was present in 15 patients and multiple abscesses were present in 4. The average drainage duration was 26 days. Successful treatment was obtained in 16 of 19 (84%) cases. One abscess recurred and was cured by repeat drainage. Two patients died. Reviewing 14 reports from the literature with a total of 252 patients treated percutaneously, an overall success rate of 77% and a mortality rate of 6% was found.     

Medical treatment of hepatic amebic abscess: rare need for percutaneous drainage

Although amebic liver abscess can virtually always be successfully treated medically, percutaneous drainage has been advocated recently. In 96 recently treated patients, therapeutic aspiration and percutaneous drainage were rarely needed. Most cases were correctly diagnosed by means of clinical, laboratory, and sonographic findings. Abscesses in only 13 (13.5%) patients were diagnostically aspirated. An abscess in one patient was therapeutically aspirated because the patient was responding slowly to medical therapy. No patient required catheter drainage. The key to successful amebic abscess management is medical therapy. Therapeutic drainage is rarely needed. Successfully treated patients occasionally respond slowly to medical therapy, and successfully treated amebic abscesses may enlarge or become bizarre-appearing on sonograms. This should not prompt therapeutic drainage. Diagnostic aspiration is appropriate when amebic and pyogenic abscesses are indistinguishable using clinical and imaging findings. Rare indications for therapeutic aspiration or drainage include pyogenic superinfection and large, juxtacardiac abscesses (potential intrapericardial rupture).     

超声介入治疗细菌性肝脓肿的两种方法疗效比较

 目的 对比研究超声引导下经皮肝穿刺细针抽吸术与置管引流术治疗细菌性肝脓肿的疗效。方法 细菌性肝脓肿98例,其中直径≥5 cm 46例,直径＜5 cm 52例。对以上两种大小的脓肿,分别采取超声引导下经皮肝穿刺细针抽吸术和置管引流术两种方法治疗,比较两种方法治疗后脓肿消失时间、患者住院时间、血象、体温恢复正常时间等。结果 直径≥5 cm肝脓肿,置管引流术组在住院天数、脓腔消失时间等方面优于细针抽吸术组（P＜0.05）,在术后血象、体温恢复正常时间方面两种方法无统计学差异（P>0.05）。直径＜5 cm肝脓肿,两种方法在住院天数、脓腔消失时间、术后血象、体温恢复正常时间方面无统计学差异（P>0.05）。结论 对于直径≥5 cm、直径＜5 cm的细菌性肝脓肿,应分别首选超声引导下经皮肝穿刺置管引流术、细针抽吸术。     

Pyogenic liver abscess treated by percutaneous catheter drainage: MDCT measurement for treatment outcome

Objective

To analyze multidetector computed tomographic (MDCT) parameters in patients with pyogenic liver abscess (PLA), and to identify which parameters can be predicted percutaneous catheter drainage (PCD) treatment outcome.

Materials and methods

Clinical, laboratory and MDCT findings of 175 patients with PLA who had undergone PCD were retrospectively reviewed. All abscesses shown on MDCT were evaluated for size, margin, attenuation values, location, number of large (>3 cm) abscesses, presence of a cystic component, presence of gas, and the shortest length to the liver capsule. Univariate and multivariate analyses of the MDCT parameters that affect PCD treatment outcome was performed. For continuous data of MDCT parameters (abscess size and the shortest length), we used receiver-operating-characteristic (ROC) curve to determine the optimal cut-off values.

Results

PCD was failed in 32 patients and the overall failure rate was 18.28%. Multivariate analysis revealed that PCD failure was predicted by the presence of gas (odds ratio [OR], 42.67), a large abscess (OR 1.21), low minimal attenuation values (OR 1.02), wide range of attenuation values (OR 1.01), a shorter length to the liver capsule (OR 0.09) and lack of a cystic component (OR 0.09) of the PLA. ROC curve showed that the shortest length less than 0.25 cm and an abscess size greater than 7.3 cm were the optimal cut-off values predicting PCD treatment failure.

Conclusion

Among these MDCT parameters, gas formation within PLA was the most important predictor for PCD failure. Surgical intervention might be considered early in high-risk patients of PCD failure.     

US-guided needle aspiration and catheter drainage as an alternative to open surgical drainage for uniloculated neck abscesses

PURPOSE: To prospectively evaluate the effectiveness of ultrasound (US)-guided needle aspiration and catheter drainage as an alternative to open surgical drainage of uniloculated neck abscesses. MATERIALS AND METHODS: Fifteen consecutive patients (11 female, four male; age range from 18 days to 78 years, mean 42.5 y +/- 22.4) diagnosed with deep neck infections associated with uniloculated neck abscesses were treated. The patients were originally scheduled for surgical incision and drainage after a period of unsuccessful treatment with antibiotics. US-guided needle aspiration (in 10 patients) and US-guided catheter drainage (in five patients) were performed under local anesthesia. Open surgical drainage was performed when US-guided drainage procedures failed. RESULTS: Surgical open drainage was avoided in 13 of the 15 patients (87%). An average of 6 mL of pus was obtained in patients in the needle aspiration group and 140 mL of pus was drained by catheter. One patient had a recurrent pyogenic lymphadenitis at the same location and was treated successfully by repeated needle aspiration. No complications occurred in this study. CONCLUSION: In a selected group of patients without imminent airway obstruction, most uniloculated neck abscesses may be managed initially by US-guided needle aspiration and catheter drainage before resorting to open surgical drainage.     

CT-guided percutaneous treatment of solitary pyogenic splenic abscesses

Six patients with solitary pyogenic splenic abscesses treated by CT-guided percutaneous drainage (by catheter or needle), are presented. There were 3 unilocular, purely intrasplenic abscesses and 3 complex lesions with loculations and perisplenic involvement. Percutaneous drainage and intravenous antibiotics were curative in 4 patients. In the other 2, who had multiloculated abscesses, despite initially successful drainage, splenectomy was performed because of intractable left upper quadrant pain in one case and persistent fever and drainage of pus after 30 days in the other. These patients also developed large, sterile left pleural effusions.Solitary pyogenic splenic abcesses — particularly if uniloculated — can be effectively treated by CT-guided percutaneous drainage. Offprint requests to: F. Pombo     

Contribution of computed tomography guided percutaneous drainage of tuberculous cold abscesses adjunctive to pharmaceutical anti-tubercular treatment

Purpose

To determine the efficiency and safety of the percutaneous aspiration and drainage of rare touberculous cold abscesses under CT guidance.

Materials and methods

We retrospectively studied 63 cases of 44 patients, treated in our hospital during the last two years. They suffered from tuberculous infection complicated with tuberculous cold abscesses variously located. All these patients underwent percutaneous aspiration and drainage under CT imaging, following the trocar puncture technique. The catheter remained in place for about a week. A follow up CT scan was performed in all cases before the catheter removal. Some of the patients were under anti tuberculosis medication.

Results

All the patients had a successful recovery from the abscesses. There were no major or minor complications observed. No recurrence occurred until today.

Conclusion

CT guided percutaneous aspiration and drainage of tuberculous cold abscesses is a safe, minimal invasive and effective method of treatment. Drainage and specific antituberculosis therapy leads to a satisfactory conclusion.     

Percutaneous catheter drainage of tuberculous and nontuberculous psoas abscesses

Objective: To assess the utility of percutaneous catheter drainage in the management of tuberculous and nontuberculous psoas abscesses associated without any bony involvement or with minimal bony lesions that could not cause vertebral instability. Materials and method: Eleven patients with psoas, iliopsoas and pelvic abscesses were drained under computed tomography and ultrasono-graphy guidance. Results: There were 15 (10 tuberculous, 5 pyogenic) abscesses in 11 patients. Six of the tuberculous abscesses and one of the pyogenic abscess were associated with vertebral involvement. Vertebral lesions were located in one or two vertebrae without causing any serious disturbance in the vertebral stabilization. In one case, the abscess was bilateral. Nine cases were drained under computed tomography guidance, while two cases were drained under both computed tomography and ultrasonography guidance. One session drainage was sufficient for abscess resolution in uniloculated cases. In the two of four multiloculated cases, catheter drainage was performed twice. Relapse of the abscess was found in only one patient. The mean abscess volume was 520 ml and mean drainage duration was 12 days. None of the cases required surgery. Conclusion: Percutaneous drainage, chemotherapy and additional external brace application with the cases associated with bony lesion may be used for treatment of tuberculous and nontuberculous unilocule and multiloculated abscesses.     

细菌性肝脓肿高危因素的多元回归分析

目的　确定近年细菌性肝脓肿治疗结果和与死亡有关的高危因素。方法　对 95例细菌性肝脓肿资料采用单因素和多元回归分析。结果　 71例采用经皮肝穿刺引流 (PCD) ,6 8例治愈 ;13例肝部分切除术加胆肠吻合均治愈 ;12例 (含穿刺引流失败后开腹引流 1例 )接受开腹引流 ,术后死亡 4例。黄疸、感染性休克、多发性脓肿、继发于恶性肿瘤、手术引流等与预后不良有关。低白蛋白血症、凝血酶原时间延长、胆红素、丙氨酸转氨酶、尿素氮、肌酐增高等是死亡率增加的独立高危因素。结论　PCD具有创伤小和预后好等优点 ,尤其适用于有各种高危因素的病人。局限于肝脏某一部位的胆源性肝脓肿 ,肝部分切除可获得良好效果。开腹引流的费用和死亡率较高 ,临床应用逐渐减少。单纯抗生素治疗对于具有高危因素的细菌性肝脓肿很少能取得满意效果     

Percutaneous treatment of large pyogenic liver abscess

Surgical drainage has been the traditional mode of treatment of pyogenic liver abscess but this was replaced by IV broad-spectrum antibiotics and imaging-guided percutaneous drainage either via needle aspiration or percutaneous catheter drainage (CD). There is a debate about which is better intermittent needle aspiration or CD.     

CT differentiation of pyogenic liver abscesses caused by Klebsiella pneumoniae vs non-Klebsiella pneumoniae

Objective

Klebsiella pneumoniae is one of the organisms most commonly isolated from pyogenic liver abscesses in Asian populations. We compared CT findings in liver abscesses caused by K. pneumoniae with those caused by other bacterial pathogens.

Methods

Of 214 patients with liver abscesses examined over a 5 year period, 129 patients with positive blood or aspirate cultures were enrolled. The patients were divided into two groups: the K. pneumoniae monomicrobial liver abscess (KLA) group (n = 59) and the non-K. pneumoniae monomicrobial or polymicrobial liver abscess (non-KLA) group (n = 70). Two radiologists blinded to the culture results evaluated the CT images, recording the number, size, location and configuration of abscesses, the thickness of the abscess wall, the pattern of rim enhancement, septal enhancement, the double target sign, internal necrotic debris, internal gas bubbles and underlying biliary disease. The presence of diabetes and metastatic infection was also compared between groups. Statistical analyses were performed using univariate (Student''s t-test and χ² test) and multivariate analyses.

Results

Multivariate analysis showed that a thin wall, necrotic debris, metastatic infection and the absence of underlying biliary disease were the most significant predictors of KLA. When three of the four criteria were used in combination, a specificity of 98.6% was achieved for the diagnosis of KLA.

Conclusion

A thin-walled abscess, internal necrotic debris, the presence of metastatic infection and the absence of underlying biliary disease may be useful CT findings in the early diagnosis of K. pneumoniae liver abscesses.Pyogenic liver abscesses are caused by a wide range of bacteria. Escherichia coli was previously the most common causative pathogen of pyogenic liver abscesses. Recently, however, Klebsiella pneumoniae has become the leading cause of pyogenic liver abscesses in many Asian populations and in some Western populations [1-6].There are several distinct clinical differences between K. pneumoniae liver abscesses (KLA) and non-K. pneumoniae liver abscesses (non-KLA). First, compared with other bacterial liver abscesses, KLA are associated with a higher frequency of bacteraemia and the potential for metastatic infection in other parts of the body. Although the mortality rate is generally lower for KLA than for non-KLA (4.1 vs 20.8%), the prognosis of KLA is often poor in patients with metastatic infection [6]. Second, ampicillin is ineffective against KLA because K. pneumoniae is intrinsically resistant to ampicillin. The preferred antibiotics for KLA are aminoglycoside and extended-spectrum β lactams. Thus, a high index of suspicion for KLA should be maintained when selecting antibiotic coverage. Third, non-KLA occur in patients with underlying biliary disease, whereas KLA frequently occur in the absence of any underlying biliary disease or predisposing medical condition [2-8].Although the early recognition of KLA is important, the differentiation between KLA and non-KLA can be difficult. In fact, the clinical presentation and laboratory findings of patients with KLA are similar to those of patients with other pyogenic liver abscesses. Blood or pus culture is the standard method for the identification of bacterial pathogens, but these methods require several days to produce results, thus delaying treatment.Imaging modalities, such as ultrasonography and CT, have been used to diagnose liver abscesses, to identify possible causes and to rule out other intra-abdominal conditions that cause similar symptoms [9,10]. However, only a few reports regarding the use of ultrasonography or CT in the differentiation of KLA and non-KLA have been published [11,12]. To our knowledge, there is only one published report on distinctive CT features in the differentiation of KLA and non-KLA [12], and no report has identified predictors that can be used to distinguish KLA from other bacterial liver abscesses using CT images. Thus, the purpose of our study was to retrospectively compare the clinical and CT features of pyogenic liver abscesses caused by K. pneumoniae and other bacterial pathogens, and to identify differences that may assist in differential diagnosis.     

超声引导下肝脓肿介入治疗的临床研究

目的 :比较超声引导下针刺抽吸术与置管引流术在肝脓肿治疗中的优劣。方法 :将 30例肝脓肿患者随机分组 ,针刺抽吸组 15例 ,置管引流组 15例 ,针刺抽吸组最多行两次抽吸 ,第二次抽吸失败后改为量管引流 ,此类患者不包括在置管引流组。观察比较两组患者治疗结果、住院天数及并发症等 ,每 3天行超声检查。结果 :针刺抽吸组有效率6 6 6 7% ,置管引流组有效率 10 0 % ,有效治愈患者中 ,两种方法临床进展 (局部症状及体征缓解、体温下降、白细胞数正常 )所需平均时间及住院平均天数相似 (P >0 0 5 ) ,尽管针刺抽吸组脓腔直径由原来减小 5 0 %所需时间明显多于置管引流组 (13天 /6天 ) (P 0 0 5 ) ,但两组患者脓腔完全或近乎完全消失所需平均时间相似 (P >0 0 5 ) ,两组患者都未见主要并发症。结论 :从脓腔缩小 5 0 %所需时间及有效率来说 ,置管引流较针刺抽吸更有效。     

Image-guided percutaneous treatment of abdominal-pelvic abscesses: a 5-year experience

Purpose

This study was undertaken to evaluate the efficacy of image-guided percutaneous drainage in treating abdominal and pelvic abscesses.

Materials and methods

From August 2001 to August 2006, 95 patients (49 men and 46 women; mean age 61 years, range 25–92) with 107 abscesses underwent image-guided percutaneous drainage. Thirty-one abscesses were retroperitoneal (9 peripancreatic, 17 perirenal, 5 pararenal), 37 intraperitoneal (2 in communication with the small bowel), 8 intrahepatic (2 in communication with the extrahepatic biliary system and 2 with the intrahepatic biliary system), 4 perisplenic and 27 pelvic (4 in communication with the large bowel). Seventy-one of 107 procedures were performed with ultrasonographic (US) guidance and 36/107 with computed tomography (CT) guidance. All procedures were carried out with 8-to 14-Fr pigtail drainage catheters.

Results

Immediate technical success was achieved in 107/107 fluid collections. No major complications occurred. In 98/107 abscesses, we obtained progressive shrinkage of the collection (>50%) with consequent clinical success. In 9/107 cases, percutaneous drainage was unable to resolve the fluid collection. There were 12 cases of catheter displacement and six of obstruction.

Conclusions

Percutaneous drainage is feasible and effective in treating abdominal and pelvic abscesses. It may be considered both as a preparatory step for surgery and a valuable alternative to open surgery. Failure of the procedure does not, however, preclude a subsequent surgical operation.     

Differentiation of pyogenic and fungal brain abscesses with susceptibility-weighted MR sequences

Introduction

Conventional magnetic resonance imaging (MRI) techniques are insufficient to determine the causative agent of brain abscesses. We investigated: (1) the value of susceptibility-weighted MR sequences (SWMRS) in the differentiation of fungal and pyogenic brain abscesses; and (2) the effect of different SWMRS (susceptibility-weighted imaging (SWI) versus venous blood oxygen level dependent (VenoBOLD)) for the detection of specific imaging characteristics of pyogenic brain abscesses.

Methods

We studied six patients with fungal and ten patients with pyogenic brain abscesses. Imaging characteristics on conventional MRI, diffusion-weighted imaging (DWI) and SWMRS were recorded in all abscesses. All lesions were assessed for the presence of a “dual-rim sign” on SWMRS.

Results

Homogenously hyperintense lesions on DWI were present in 60 % of patients with pyogenic abscesses, whereas none of the patients with fungal abscesses showed such lesions. On SWMRS, 90 % of patients with pyogenic abscesses and 60 % of patients with fungal abscesses had only lesions with a low-signal-intensity rim. On SWI, the dual-rim sign was apparent in all pyogenic abscesses. None of the fungal abscesses on SWI (P?=?0.005) or any of the pyogenic abscesses on VenoBOLD (P?=?0.005) were positive for a dual-rim sign.

Conclusions

In fungal abscesses, the dual-rim sign is not present but a prominent peripheral rim or central susceptibility effects on SWI will be seen. The appearance of pyogenic abscesses on SWMRS depends on the used sequence, with the dual-rim sign a specific feature of pyogenic brain abscesses on SWI.     

Breast abscess in lactating women: US-guided treatment

PURPOSE: To retrospectively evaluate the use of ultrasonography (US)-guided treatment of breast abscesses in lactating women. MATERIALS AND METHODS: One hundred eight consecutive lactating women who were clinically suspected of having a breast abscess were examined with US. Abscesses depicted at US were treated with US guidance, and the success of US-guided treatment was retrospectively determined. RESULTS: Fifty-six abscesses were identified at US in 43 women; all abscesses were treated with US guidance: 23 with needle aspiration and 33 with catheter drainage. Treatment method was determined according to the size of the abscess. Abscesses that were smaller than 3 cm in maximum diameter were treated with needle aspiration, and abscesses that were 3 cm or larger in maximum diameter were treated with catheter insertion. One patient who was treated with needle aspiration subsequently underwent surgical intervention; all others were successfully treated with US intervention. Catheter placement was well tolerated (mean pain score 2.3 in 22 women by using a subjective pain scale of 0-10). CONCLUSION: US-guided needle aspiration of abscesses smaller than 3 cm and US-guided catheter drainage of abscesses 3 cm or larger are successful means of treating breast abscesses.     

Percutaneous Treatment of Simple Hepatic Cysts: The Long-Term Results of PAIR and Catheterization Techniques as Single-Session Procedures

Purpose

The purpose of our study is to evaluate results of percutaneous aspiration with alcohol sclerotherapy in symptomatic patients with simple hepatic cysts by employing single-session techniques either by a needle or a catheter.

Materials and Methods

We retrospectively included 39 simple hepatic cysts in 35 patients treated via percutaneous aspiration and single-session alcohol sclerotherapy between years 1993 and 2012. Indications were pain (n = 28) or ruling out cystic echinococcus (CE) disease (n = 7). 29 cysts in 26 patients were treated by needle technique (Group A) and ten cysts in nine patients were treated by single-session catheter technique (Group B). Patients were followed for 4–173 months (median: 38 months).

Results

All patients were successfully treated. Before procedure, cyst volumes were 21–676 cc (median: 94 cc). Post-procedure cyst volumes at last follow-up were 0-40 cc (median: 1 cc). The mean decrease in cyst volume was 95.92 ± 2.86 % in all patients (95.96 ± 3.26 % in Group A and 95.80 ± 6.20 % in Group B). There was no statistically significant difference between the volume reduction rates of Group A and Group B. Only one patient, in Group B, developed a major complication, an abscess. Hospitalization period was 1 day for all patients.

Conclusions

For patients with symptomatic simple hepatic cysts smaller than 500 cc in volume by using puncture, aspiration, injection, and reaspiration (PAIR) technique with only needle, single-session alcohol sclerotherapy of 10 min is a safe and effective procedure with high success rate.