SURGERY FOR ADULT POLYCYSTIC LIVER-DISEASE

Background. Occasionally patients with adult polycystic liver disease (APLD) have symptoms. For these patients surgery may represent a valua ble therapeutic option to relieve symptoms. Methods. From September 19 77 to August 1993 at our institution, 10 women with APLD were examined and surgically treated. They underwent a partial hepatic resection to gether with cyst fenestration. The surgical outcome and long-term foll ow-up were retrospectively analyzed. Results. Postoperative morbidity consisted of one case of pneumonia, and one case of acute pancreatitis with deep vein leg thrombosis. One patient died after acute Budd-Chia ri syndrome developed as a result of liver collapse after fenestration of a posterior cyst. In the long term six of nine patients were sympt om free. Late surgical complications included acute cholecystitis (one patient), small bowel obstruction (one), and incisional hernia (two). Conclusions. A combined surgical approach of hepatic resection and cy st fenestration has Proved feasible for patients with highly symptomat ic APLD. Extensive fenestration of posterior posterior cysts should be avoided; transverse hepatic resection (frontal hepatectomy) up to the costal margin is proposed. This therapy provides good results at long -term follow-up.