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Treatment of polycystic liver disease with resection-fenestration and a new classification

Treatment of polycystic liver disease with resection-fenestration and a new classification

作     者:Tuan-Jie Li Hai-Bin Zhang Jun-Hua Lu Jun Zhao Ning Yang Guang-Shun Yang 

作者机构:Eastern Hepatobiliary Hospital Second Military Medical University Shanghai 200438 China 

出 版 物:《World Journal of Gastroenterology》 (世界胃肠病学杂志(英文版))

年 卷 期:2008年第14卷第32期

页      面:5066-5072页

核心收录:

学科分类:1002[医学-临床医学] 100210[医学-外科学(含:普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

主  题:Autosomal dominant polycyst liverdisease Autosomal dominant polycyst kidney disease Fenestration 

摘      要:AIM: To evaluate outcomes in patients with autosomal dominant polycyst liver disease (APLD) treated by combined hepatic resection and fenestration. A new classification was recommended to presume postoperative complications and long outcome of patients. METHODS: Twenty-one patients with APLD were treated by a combined hepatic resection and fenestration technique. All patients were reviewed retrospectively, and clinical symptoms, performance status and morbidity were recorded. A new classifi cation of APLD is recommended here. RESULTS: All patients were discharged when free of symptoms. The mean follow-up time was 55.7 mo and three patients had a recurrence of symptoms at 81, 68 and 43 mo after operation, respectively. The overall morbidity rate was 76.2%. Two patients with Type B-Ⅱ and Type B-Ⅰ developed biliary leakage. Four patients had severe ascites, including three with Type B-Ⅲ and one with Type B-Ⅱ, Nine patients had pleural effusion, including one with Type A-Ⅰ; one with Type B-Ⅰ; fi ve with Type B-Ⅱ; one with Type A-Ⅲ and one with Type B-Ⅲ. Three patients with Type B had recurrence of symptoms, while none with Type A had severe complications. CONCLUSION: Combined hepatic resection and fenestration is an acceptable procedure for treatment of APLD. According to our classifi cation, postoperative complications and long outcome can be predicted before surgery.

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