4.5 Article

Operative Outcomes for Polycystic Liver Disease: Results of a Large Contemporary Series

Journal

JOURNAL OF GASTROINTESTINAL SURGERY
Volume -, Issue -, Pages -

Publisher

SPRINGER
DOI: 10.1007/s11605-023-05843-1

Keywords

Polycystic liver disease; Hepatectomy; Laparoscopy

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This study provides evidence that surgical debulking is a safe and effective treatment option for patients with symptomatic polycystic liver disease (PCLD). The study also suggests that patients undergoing hepatectomy for PCLD can tolerate significant liver volume reduction without impaired hepatic function.
IntroductionPersistent symptoms of pain, early satiety, dyspnea, and gastrointestinal reflux due to significant liver enlargement are indications for surgical debulking in patients with polycystic liver disease (PCLD) due to the lack of effective medical therapies; however, few data exist on outcomes of surgical intervention for PCLD.MethodsWe conducted a retrospective analysis of consecutive patients who underwent operative intervention due to persistent symptoms secondary to PCLD. Preoperative patient characteristics, 30-day postoperative outcomes, and long-term postoperative outcomes, including complications and symptom resolution, were analyzed.ResultsWe identified 50 patients who underwent hepatic resection for symptomatic PCLD. Nine patients (19%) had concomitant polycystic kidney disease, and 14 (28%) had previously undergone interventions for PCLD management. The overall complication rate was 30%, with 8 patients (16%) experiencing Clavien-Dindo Grade III-V complications and no mortalities. The median relative reduction in liver volume was 41%. At a median follow-up of 2 years, 94% has sustained symptom resolution.ConclusionsThis is among the largest case series exploring PCLD operative outcomes, revealing that surgical intervention for debulking for advanced PCLD is safe and effective for symptom management. Furthermore, patients with PCLD undergoing hepatectomy tolerate significant liver volume loss without evidence of impaired hepatic function.

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