TREATMENT OF SYMPTOMATIC HEPATIC CYSTS BY PERCUTANEOUS INSTILLATION OF MINOCYCLINE HYDROCHLORIDE

Nine patients with 16 symptomatic nonneoplastic congenital hepatic cys ts were treated prospectively by ultrasonically guided percutaneous mi nocycline hydrochloride injection, and the usefulness of this treatmen t was evaluated. Seven of the patients had multiple hepatic cysts, and two solitary cysts. Ail the patients were women, ranging in age from 36 to 81 years. After cystic fluid had been aspirated with a 21-gauge PTC needle, minocycline hydrochloride was injected into all the cysts. The minocycline hydrochloride was dissolved in saline at a concentrat ion of 200 mg in 9 mi, and mixed with 1 mi of 2% mepivacaine hydrochlo ride. The total quantity of minocycline hydrochloride injected varied from 100 mg to 1200 mg per hepatic cyst, depending on its size. Total or subtotal regression of the cysts was observed in all patients durin g follow-up periods ranging from 15 to 35 months. Seven patients becam e symptom-free, one showed symptom reduction, and one showed no change in symptoms. Minor side effects, eg, transient abdominal pain, slight right shoulder pain, and temperature elevation, were noted in three p atients respectively. On the basis of these results, we conclude that ultrasonically guided percutaneous minocycline hydrochloride injection is useful for the treatment of symptomatic hepatic cysts.