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Polcystic disease of the liver




Introduction. Policystic liver disease is an infrequent entity that predominantly affects women, characterize by the presence of multiple cysts in the liver and kidney that produce compression by mass effect.


Materials and methods. The patient is a 53 year old woman that was first seen in the outpatient clinic referred by the Hospital de Yopal because of an abdominal mass, diminished food intake during the past eight months, whose CT scan showed giant cysts in the liver and cysts in the kidneys.


Results. Unroofing of three cysts located in both hepatic lobes and echographic-guided sclerosis of a fourth giant cyst of central location was performed; there was much improvement of symptoms of pain and sensation of mass, with betterment in the nutritional intake.


Discussion. Surgical management by laparoscopic technique of the polcystic disease of the liver is feasible, even in cases where cysts are located in the posterior segments where laparoscopic approach has been contraindicated by some authors. It is also possible to treat these patients by a combined method of percutaneous drainage for sclerosing the cysts, always considering their location and the state of hepatic function, so as to preserve healthy hepatic tissue in patients with abnormal liver function.


Key words: liver, liver diseases, liver function tests, laparoscopy, sclerosis.






1. O’SULLIVAN DA, TORRES VE, DE GROEN PC, BATTS KP, KING BF, VOCKLEY J, et al. Hepatic lymphangiomatosis mimicking polycystic liver desease. Mayo Clin Proc. 1998;73:1188-92.


2. TROTTER JF, EVERSON GT. Benign focal lesions of the liver. Clin Liver Dis. 2001;5:17-42.


3. DEBAKEY ME, JORDAN GL JR. Cirugía del hígado. En: Schiff L, Alpers DA, Arias IM, Baggenstoss AH, Baldus WP, Billing PA, et al., editores. Enfermedades del hígado. 4ª edición. Barcelona: Salvat; 1980. p. 1247.


4. TIKKAKOSKI T, MAKELA JT, LEINONEN S, PÄIVANSÄLO M, MEKIKANTO J, KARTTUNEN A, et al. Treatment of symptomatic congenital hepatic cysts with single-session percutaneous drainage and ethanol sclerosis: technique and outcome. J Vasc Interv Radiol. 1996;7:235-9.


5. LARSSEN TB, VISTE A, JENSEN DK, SONDEAN K, ROLLE O, HORN A. Single-session alcohol sclerotherapy in bening symptomatic hepatic cysts. Acta Radiol. 1997;38:993-7.


6. SRINIVASAN R. Polycystic liver disease: an unusual cause of bleeding varices. Dig Dis Sci. 1999;44:389-92.


7. EVERSON GT, EMMETT M, BROWN WR, REDMOND P, THICKMAN D. Functional similarities of hepatic cystic and biliary epithelium: studies of fluid constituents and in vivo secretion in response to secretin. Hepatology. 1990;11:557-65.


8. FABIANI P, MAZZA D, TOOULI J, BARTELS AM, GUGENHEIM J, MOUIEL J. Laparoscopic fenestration of symptomatic nonparasitic cysts of the liver. Br J Surg. 1997;84:321-2.


9. CRAWFORD JM. Hígado y vías biliares. En: Cotran RS, Kumar V,  Robbins SL, Schoen FJ, editores. Robbins, Patología estructural y funcional. 5ª edición. México: Interamericana McGraw-Hill; 1998;919-76.


10. SURÓS J, SURÓS A. Surós semiología médica y técnica exploratoria. 7ª edición. Barcelona: Salvat Editores; 1987;341-525.


11. BIRNBAUM E, MYERSON RJ. Carcinoma del ano. En: Zinner MJ, Schwartz SI, Ellis H, Ashley SW, McFadden DW, editores. Maingot, Operaciones abdominales 10ª edición. Buenos Aires: Panamericana; 1998;1403-9.


12. SCHWARTZ SI. Hígado. En: Schwartz SI, Shires GT, Fischer JE, Spencer FC, Galloway AC, Daly JM, editores. Principios de cirugía. 7ª edición. México: McGraw-Hill Interamericana; 1999;1487-529.


13. ALDRETE SJ. Resecciones hepáticas. En: Samperio GC, Arrubarrena AVM, editores. Fisiopatología quirúrgica del aparato digestivo. 2ª edición. México: D.F.: El Manual Moderno; 1996;491.


14. TERADA T, NOTSUMATA K, NAKANUMA Y. Biliary carcinosarcoma arising in nonparasitic simple cyst of the liver. Virchows Arch. 1994;424:331-5.


15. EVERSON GT, SCHERZINGER A, BERGER-LEFF N, REICHEN J, LEZOTTE D, MANCO-JOHNSON M, et al. Polycystic liver disease: quantitation of parenchymal and cyst volumes from computed tomography. Images and clinical correlates of hepatic cysts. Hepatology. 1998;8:1627-34.


16. WEBB WR, BRANT WE, HELMS CA. Fundamentos de TAC body. Madrid: Editorial Marban; 1993. p. 139.


17. DÍAZ JA, DURAN CM. Drenaje de quiste hepático no parasitario mediante cirugía laparoscópica. Reporte de un caso. Asociación Mexicana Cirugía Endoscópica. [en línea] 2004;5(1). Disponible en: ce041h.pdf.


18. DÍAZ E, MEDINA JL. Diagnóstico por laparoscopia de un quiste hepático simple. Gac Med Mex. 2001;137:265-6.


19. ROESCH DF, PÉREZ MA, DÍAZ BF, MARTÍNEZ FS. Tratamiento quirúrgico laparoscópico del quiste hepático no parasitario. Rev Gastroenterol Mex. 1999;64:56-9.


20. MANTEROLA C, PINEDA V, VIAL M. Efectividad del tratamiento laparoscópico de quistes y tumores hepáticos: revisión global de la evidencia. Rev Chil Cir. 2007;59:264-71.


21. NICOLUZZI JE, GUIMARÃES M, MONTEIRO MR, REPKA JC, CARON PE. Tratamento laparoscópico de cistos hepáticos sintomáticos. Arq Bras Cir Dig. 2004;17:100-2.


22. LÓPEZ J, BASTARDO MA, HERNÁNDEZ JA, LEÓN N. Manejo mínimamente invasivo de los quistes hepáticos simples: uso del bisturí armónico. Rev Venez Cir. 2003;56:130-7.


23. MAZZA O, MORO M, ARBUES G, QUIÑÓNEZ E, STORK G, SÁNCHEZ R, PEKOLJ J, SANTIBÁÑES E. Actualización en el diagnóstico y tratamiento de los quistes hepáticos no parasitarios. Rev Argent Resid Cir. 2003;8:13-6.


24. ZORRILLA JO, WILCHES RO, BARBOSA G, VILLAMIZAR J, JUNCA G, OSPINA J, et al. Quistes hepáticos. Rev Colomb Gastroenterol. 2001;16:96-101.


25. KATKHOUDA N, HURWITZ M, GUGENHEIM J, et al. Laparoscopic management of benign solid and cystic lesions of the liver. Ann Surg. 1999;229:460-6.


26. MANTEROLA C, PINEDA V, et al. Efectividad del tratamiento laparoscópico de quistes y tumores hepáticos. Revisión global de la evidencia. Rev Chilena de Cirugía. 2007;59:264-71.




Correo electrónico:

Bogotá, D.C., Colombia. 





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