Efficacy and Related Factors of Ultrasound-guided Lauromacrogol Injection in Treating Symptomatic Hepatic Cysts with a Diameter of <10 cm: A Retrospective Study

TL;DR

This study shows that lauromacrogol injection is effective for treating small symptomatic liver cysts, but the formation of internal walls in the cyst after treatment can reduce its effectiveness.

Contribution

The study identifies septa formation after cyst sclerosis as an independent factor related to treatment failure in hepatic cysts.

Findings

Lauromacrogol injection had a 96.1% effective rate in treating symptomatic hepatic cysts under 10 cm.

Septa formation after treatment was an independent factor associated with treatment failure.

Initial cyst volume and diameter were significant factors influencing treatment outcomes.

Abstract

This study aimed to retrospectively analyze the curative effect and influencing factors of lauromacrogol in the treatment of symptomatic hepatic cysts of <10 cm.

In this study, a total of 51 patients with symptomatic hepatic cysts (maximum diameter ranging from 5 cm to 10 cm) were included. Polycystic Liver Disease Questionnaire (PLD-Q) was used to evaluate the symptoms of patients prior to treatment. The patients were followed up at 1, 3, 6, and 12 months after treatment. At the 12-month follow-up, patients were asked to fill out the PLD-Q to assess their symptoms. The improvement rate of patients' symptoms was evaluated using a 5-point Likert scale (worse, 1; slight difference, 2; roughly the same, 3; good, and 4; better, 5. Volume reduction rate (VRR) was calculated by measuring the volume of the cyst cavity via ultrasound. Treatment success at the 12-month follow-up was determined using two criteria: symptom improvement and changes in cyst volume. Symptom improvement was assessed using a Likert Scale, with a score greater than 3 points indicating significant improvement. Additionally, a volume reduction rate (VRR) of 50% or more in cyst size (VRR ≥ 50%) was considered an effective treatment outcome. The relationship between the clinical factors and the ultrasonographic manifestations of hepatic cysts, including the initial maximum diameter of the cyst (measured using ultrasound before operation), the initial volume of the cyst, and the formation of septa after sclerosis of the cyst, was analyzed.

All patients completed at least 12 months of follow-up. After a 12-month follow-up, the effective and ineffective rates were 96.1% (49/51) and 3.9% (2/51), respectively. The logistic regression univariate analysis showed significant differences in the initial cyst volume (p = 0.001), the initial maximum diameter of the cyst (p = 0.005), and the interval formation after cyst sclerosis (p = <0.001) between VRR ≥ 50% and VRR < 50%. Logistic regression analysis demonstrated that septa formation after cyst sclerosis was an independent factor related to treatment failure, with an odds ratio of 3.246 (95% confidence interval, 0.784–4.148).

Lauromacrogol is an effective method for hepatic cyst treatment. Septa formation after cyst sclerosis is an independent factor related to ineffective treatment.

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