BACKGROUND: Partial hepatectomy and cyst fenestration (PHCF) selectively provides clinical benefit in highly symptomatic patients with polycystic liver disease (PLD). This study aims to ascertain whether the reduction in liver volume (LV) achieved by PHCF is sustained long term. STUDY DESIGN: Clinical data were retrieved from the electronic records of all patients with PLD who underwent PHCF between 1985 and 2014. Preoperative LVs (LV1), postoperative LVs (LV2), and late follow-up LVs (LV3) were measured from magnetic resonance or CT images. RESULTS: Among 186 patients who underwent PHCF, 91% were Caucasian women with autosomal dominant polycystic kidney disease with a mean age of 49 years. Major perioperative complications (Clavien III/IV) occurred in 21% of the patients. Operative mortality (<90 days) was 2.7%. Eleven patients had liver failure develop, received liver transplants, or had liver-related deaths. Overall survival was 95.7%, 93.3%, 85.6%, and 77.7% at 1, 5, 10, and 15 years respectively. Imaging records for volumetry were unavailable in 32 patients. Of the remaining 154 patients, 34 had imaging for 1 LV, 64 for 2 LVs, and 55 for all 3 LVs. Median LV was 6,781 mL (interquartile range 4,903 to 8,341 mL) preoperatively and 2,502 mL (interquartile range 2,089 to 3,136 mL) after PHCF, leading to a median postoperative LV reduction of 61%. At follow-up (mean 8 years), median LV was 2,519 mL (interquartile range 2,083 to 3,752 mL). Interestingly, 33 of 62 patients with available LV2 and LV3 showed additional regression in LV at follow-up (median -14.1%), and the rest showed mild growth of 9.9%. Overall volumetric comparison of preoperative with follow-up liver imaging showed sustained LV reduction (median 61%). CONCLUSIONS: Sustained long-term reductions in LV after PHCF can be achieved in selected patients with severe, highly symptomatic PLD. In our experience, liver-related death and subsequent liver transplantation are infrequent after PHCF.
BACKGROUND: Partial hepatectomy and cyst fenestration (PHCF) selectively provides clinical benefit in highly symptomatic patients with polycystic liver disease (PLD). This study aims to ascertain whether the reduction in liver volume (LV) achieved by PHCF is sustained long term. STUDY DESIGN: Clinical data were retrieved from the electronic records of all patients with PLD who underwent PHCF between 1985 and 2014. Preoperative LVs (LV1), postoperative LVs (LV2), and late follow-up LVs (LV3) were measured from magnetic resonance or CT images. RESULTS: Among 186 patients who underwent PHCF, 91% were Caucasian women with autosomal dominant polycystic kidney disease with a mean age of 49 years. Major perioperative complications (Clavien III/IV) occurred in 21% of the patients. Operative mortality (<90 days) was 2.7%. Eleven patients had liver failure develop, received liver transplants, or had liver-related deaths. Overall survival was 95.7%, 93.3%, 85.6%, and 77.7% at 1, 5, 10, and 15 years respectively. Imaging records for volumetry were unavailable in 32 patients. Of the remaining 154 patients, 34 had imaging for 1 LV, 64 for 2 LVs, and 55 for all 3 LVs. Median LV was 6,781 mL (interquartile range 4,903 to 8,341 mL) preoperatively and 2,502 mL (interquartile range 2,089 to 3,136 mL) after PHCF, leading to a median postoperative LV reduction of 61%. At follow-up (mean 8 years), median LV was 2,519 mL (interquartile range 2,083 to 3,752 mL). Interestingly, 33 of 62 patients with available LV2 and LV3 showed additional regression in LV at follow-up (median -14.1%), and the rest showed mild growth of 9.9%. Overall volumetric comparison of preoperative with follow-up liver imaging showed sustained LV reduction (median 61%). CONCLUSIONS: Sustained long-term reductions in LV after PHCF can be achieved in selected patients with severe, highly symptomatic PLD. In our experience, liver-related death and subsequent liver transplantation are infrequent after PHCF.
Authors: Loes van Keimpema; Frederik Nevens; René Adam; Robert J Porte; Panagiotis Fikatas; Thomas Becker; Preben Kirkegaard; Herold J Metselaar; Joost P H Drenth Journal: Transpl Int Date: 2011-09-29 Impact factor: 3.782
Authors: See Ching Chan; Chi Leung Liu; Chung Mau Lo; Banny K Lam; Evelyn W Lee; Yik Wong; Sheung Tat Fan Journal: World J Gastroenterol Date: 2006-04-14 Impact factor: 5.742
Authors: Loes Van Keimpema; Daan B De Koning; Bart Van Hoek; Aad P Van Den Berg; Martijn G H Van Oijen; Robert A De Man; Frederik Nevens; Joost P H Drenth Journal: Liver Int Date: 2011-01 Impact factor: 5.828
Authors: Fouad T Chebib; Yeonsoon Jung; Christina M Heyer; Maria V Irazabal; Marie C Hogan; Peter C Harris; Vicente E Torres; Ziad M El-Zoghby Journal: Nephrol Dial Transplant Date: 2016-02-29 Impact factor: 5.992
Authors: Kyongtae T Bae; Fang Zhu; Arlene B Chapman; Vicente E Torres; Jared J Grantham; Lisa M Guay-Woodford; Deborah A Baumgarten; Bernard F King; Louis H Wetzel; Philip J Kenney; Marijn E Brummer; William M Bennett; Saulo Klahr; Catherine M Meyers; Xiaoling Zhang; Paul A Thompson; J Philip Miller Journal: Clin J Am Soc Nephrol Date: 2005-10-26 Impact factor: 8.237
Authors: René Adam; Paul McMaster; John G O'Grady; Denis Castaing; Jurgen L Klempnauer; Neville Jamieson; Peter Neuhaus; Jan Lerut; Mauro Salizzoni; Stephen Pollard; Ferdinand Muhlbacher; Xavier Rogiers; Juan Carlos Garcia Valdecasas; Joaquin Berenguer; Daniel Jaeck; Enrique Moreno Gonzalez Journal: Liver Transpl Date: 2003-12 Impact factor: 5.799
Authors: Lucas H P Bernts; Myrte K Neijenhuis; Marie E Edwards; Jeff A Sloan; Jenna Fischer; Rory L Smoot; David M Nagorney; Joost P H Drenth; Marie C Hogan Journal: Surgery Date: 2020-05-08 Impact factor: 3.982
Authors: Carsten Bergmann; Lisa M Guay-Woodford; Peter C Harris; Shigeo Horie; Dorien J M Peters; Vicente E Torres Journal: Nat Rev Dis Primers Date: 2018-12-06 Impact factor: 52.329
Authors: Whitney Besse; Ke Dong; Jungmin Choi; Sohan Punia; Sorin V Fedeles; Murim Choi; Anna-Rachel Gallagher; Emily B Huang; Ashima Gulati; James Knight; Shrikant Mane; Esa Tahvanainen; Pia Tahvanainen; Simone Sanna-Cherchi; Richard P Lifton; Terry Watnick; York P Pei; Vicente E Torres; Stefan Somlo Journal: J Clin Invest Date: 2017-04-04 Impact factor: 14.808
Authors: Kyongtae T Bae; Cheng Tao; Robert Feldman; Alan S L Yu; Vicente E Torres; Ronald D Perrone; Arlene B Chapman; Godela Brosnahan; Theodore I Steinman; William E Braun; Michal Mrug; William M Bennett; Peter C Harris; Avantika Srivastava; Douglas P Landsittel; Kaleab Z Abebe Journal: Clin J Am Soc Nephrol Date: 2022-02-25 Impact factor: 10.614