Ultrasound‐guided polidocanol foam sclerotherapy for symptomatic giant hepatic cyst: A single‐center experience

Aim Simple hepatic cysts are typically benign; however, when they are large and symptomatic, therapeutic intervention is required. We previously reported our initial experience with ultrasound (US)‐guided polidocanol foam sclerotherapy in three patients with symptomatic giant hepatic cysts. In the present study, we examined the efficacy and safety of polidocanol foam sclerotherapy in a larger number of patients with long‐term follow‐up. Methods Between May 2016 and April 2021, 15 patients with symptomatic giant hepatic cysts were referred to our hospital. All patients were prospectively included in the study and underwent US‐guided polidocanol foam sclerotherapy. Results The mean maximum diameter and estimated cyst volume were 128.4 mm (77–223 mm) and 922.3 ml (123.2–2797 ml), respectively. Polidocanol foam was successfully administered through an 8.5‐Fr pigtail catheter in all patients. The percentages of cyst diameter/volume after 1–3 months, 3–6 months, 6 months–1 year, 1–2 years, and 2–4 years of sclerotherapy were 66.8%/36.5%, 48.1%/14.8%, 34.1%/6.9%, 28.2%/3.7%, and 26.2%/3.1%, respectively. During the follow‐up period, there were no cases of symptom recurrence or need for additional treatment due to cyst re‐growth. Six patients (40%) had fever, one had nausea, and one had right‐sided chest pain, but none of these adverse events required prolonged hospitalization or readmission. Conclusions US‐guided polidocanol foam sclerotherapy may be an effective and safe method for the treatment of symptomatic giant hepatic cysts.