Treatment of Polycystic Liver Disease with Hepatomegaly
This protocol addresses symptomatic polycystic liver disease presenting with hepatomegaly, confirmed to be free of cyst hemorrhage and cyst infection — a specific clinical subset in which management is directed at reducing hepatic volume.
Clinical scenario: Symptomatic polycystic liver disease with hepatomegaly, in the absence of cyst hemorrhage and cyst infection. The treatment aim in this setting is to reduce the volume of hepatomegaly, distinct from the management of acute cyst complications.
Surgical approach (partial overview): Management involves a combined surgical strategy: resection targeting the portion of the liver where cysts are most concentrated, paired with a complementary procedure on the opposite side. The complete operative criteria, technique selection, and decision algorithm are detailed in the full protocol.
References
DOI: 10.1016/j.jviscsurg.2018.07.004
In symptomatic patients, the treatment goal is to reduce the volume of hepatomegaly, except for the two special cases of hemorrhage and infection.
Resection of the portion of the liver where cysts predominate was proposed by the Mayo Clinic team in 1995 and is based on the usual inhomogeneous nature of cystic liver disease with sparing of one or more areas of parenchyma that will enlarge through regeneration.
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