DIAGNOSIS AND THERAPEUTIC POLICY IN POLYCYSTOSIS OF THE LIVER

The results of clinical observations of 60 patients with polycystosis of the liver who had been treated or examined by the authors in the pe riod from 1964 to 1989 were summarized. The clinical course of the dis ease was featured by scanty clinical signs: pains in the upper half of the belly and hepatomegalia were most frequent. The combination of di agnostic techniques for verification of surgical intervention necessit y was established. Besides, it was stated that the diagnosis of polycy stosis of the liver should be complex and based on anamnestic data and the results of clinical, laboratory and instrumental investigations. Preference should be given to ultrasonography and computed tomography. Cysts with diameter of 5 cm and more, complicated polycystosis of the liver (bleeding, purulation, malignancy) and cystic compression of th e extrahepatic bile ducts and vessels (portal and cava inferior veins) were found to be indicative signs for surgical treatment of hepatic p olycystosis. A total of 41 patients were subjected to surgical treatme nt with 49 operational procedures employed. Fenestration of hepatic cy sts (42), that were organosparing operations, predominated. Resection of the liver was performed in 2 patients who had total cyst substituti on for the whole of the left lobe. The improvement registered in 85.7 % of operated on patients evidenced the favorable results of surgical treatment.