Treatment of simple, benign, epithelialized hepatic cysts.
- Epithelialized hepatic cysts can be drained successfully and obliterated with sclerotherapy.
- A self-retaining, pigtail catheter can be used. After catheter placement with US or CT guidance, and complete cyst aspiration, samples are sent for culture and cytologic examination.
- Contrast is injected through the catheter under fluoroscopic guidance to ensure that there is no communication with the biliary tree. If no connection to the bile ducts is demonstrated, then 33% to 50% of the original cyst volume is replaced with a sclerosant.
- Sclerosants used to treat hepatic cysts include ethanol (not to exceed 100 mL), tetracycline, doxycycline, and povidone-iodine.
- The patient is rotated into multiple positions until the entirety of the cyst wall has been in contact with the sclerosing agent for 60 minutes.
- The entire volume of sclerosant and residual cyst contents are then completely aspirated through the catheter. Large cysts may require repeat treatments.
- After the final treatment and aspiration, the catheter is removed.
