Repeated Minocycline Hydrochloride Injections for Symptomatic Polycystic Liver Disease

Aim : The present study evaluated the safety and effectiveness of repeated injections of minocycline hydrochloride (MINO) for symptomatic polycystic liver disease (PLD). Methods : We retrospectively studied patients who received percutaneous MINO injections for symptomatic PLD and were followed up for at least 2 years between 2002 and 2015. Huge hepatic cysts (diameter > 10 cm) were treated by continuous drainage and multiple MINO injections. Small hepatic cysts underwent one-step drainage followed by a single injection of MINO. Only several cysts that caused complications were treated by percutaneous injection of MINO. Patients were discharged 1 day after treatment. Results : Ten patients, (4men and 6 women; mean age, 57.8 years) were studied. All patients had Type 2 PLD according to Gigot’s classification. The chief complaints were abdominal distension (n = 10), abdominal pain (n = 6), back pain (n = 4), and appetite loss (n = 8). Four patients had mild liver dysfunction. One patient complained of moderate right subscapular pain immediately after the injection, and another had pain at the site of catheter insertion. Liver dysfunction did not develop in any patient after treatment. The mean follow-up was 63.4 months. The interval from the first to last admission for MINO injection therapy was 14 to 148 months (mean, 40.8 months). The number of admissions for MINO injection therapy ranged from 2 to 12 times (mean, 4.0 times). The average interval for MINO injection therapy was 8.3 to 19 months (mean, 14.8 months).The hepatic cysts shrank in all patients after treatment. Complications improved consistently, and all patients were satisfied with the outcome of treatment. Conclusions : Symptomatic PLD was controllable by 14.8 months of repeated MINO injections on average. Repeated MINO injections are a safe, definitive treatment for symptomatic PLD.

[1]  M. Mercado,et al.  Liver transplantation for polycystic liver disease. , 2014, Journal of the American College of Surgeons.

[2]  F. Dobbels,et al.  Development and validation of a polycystic liver disease complaint-specific assessment (POLCA). , 2014, Journal of hepatology.

[3]  M. Kudo,et al.  Current treatment status of polycystic liver disease in Japan , 2014, Hepatology research : the official journal of the Japan Society of Hepatology.

[4]  J. Drenth,et al.  Polycystic liver disease: an overview of pathogenesis, clinical manifestations and management , 2014, Orphanet Journal of Rare Diseases.

[5]  Olivier Farges,et al.  Hepatic cysts treated with percutaneous ethanol sclerotherapy: time to extend the indications to haemorrhagic cysts and polycystic liver disease , 2014, European Radiology.

[6]  Fengyong Liu,et al.  Treatment of symptomatic polycystic liver disease: transcatheter super-selective hepatic arterial embolization using a mixture of NBCA and iodized oil , 2013, Abdominal Imaging.

[7]  F. Nevens,et al.  Excellent survival after liver transplantation for isolated polycystic liver disease: an European Liver Transplant Registry study , 2011, Transplant international : official journal of the European Society for Organ Transplantation.

[8]  F. Nevens,et al.  Systematic review: the pathophysiology and management of polycystic liver disease , 2011, Alimentary pharmacology & therapeutics.

[9]  A. Antoniou,et al.  Biliary differentiation and bile duct morphogenesis in development and disease. , 2011, The international journal of biochemistry & cell biology.

[10]  D. Nagorney,et al.  Medical and surgical treatment options for polycystic liver disease 1 , 2010, Hepatology.

[11]  J. Drenth,et al.  Congenital fibrocystic liver diseases. , 2010, Best practice & research. Clinical gastroenterology.

[12]  E. Uchida,et al.  A case of spontaneous rupture of a simple hepatic cyst. , 2010, Journal of Nippon Medical School = Nippon Ika Daigaku zasshi.

[13]  L. Antiga,et al.  Reducing polycystic liver volume in ADPKD: effects of somatostatin analogue octreotide. , 2010, Clinical journal of the American Society of Nephrology : CJASN.

[14]  L. van Keimpema,et al.  Treatment of polycystic liver disease , 2009, The British journal of surgery.

[15]  M. Kudo,et al.  Percutaneous aspiration and ethanolamine oleate sclerotherapy for sustained resolution of symptomatic polycystic liver disease: an initial experience. , 2009, AJR. American journal of roentgenology.

[16]  M. V. van Oijen,et al.  Lanreotide reduces the volume of polycystic liver: a randomized, double-blind, placebo-controlled trial. , 2009, Gastroenterology.

[17]  T. Tajiri,et al.  Infected hepatic cyst treated with percutaneous transhepatic drainage. , 2009, Journal of Nippon Medical School = Nippon Ika Daigaku zasshi.

[18]  T. Tajiri,et al.  Intracystic hemorrhage of a large simple hepatic cyst. , 2008, Journal of Nippon Medical School = Nippon Ika Daigaku zasshi.

[19]  G. Everson,et al.  Advances in management of polycystic liver disease , 2008, Expert review of gastroenterology & hepatology.

[20]  V. Desmet,et al.  Embryology of Extra‐ and Intrahepatic Bile Ducts, the Ductal plate , 2008, Anatomical record.

[21]  C. Pinson,et al.  Surgical management of polycystic liver disease. , 2007, World journal of gastroenterology.

[22]  C. Palanivelu,et al.  Laparoscopic Management of Symptomatic Multiple Hepatic Cysts: a Combination of Deroofing and Radical Excision , 2007, JSLS : Journal of the Society of Laparoendoscopic Surgeons.

[23]  D. Gouma,et al.  Results of percutaneous sclerotherapy and surgical treatment in patients with symptomatic simple liver cysts and polycystic liver disease. , 2007, World journal of gastroenterology.

[24]  M. Manns,et al.  Outcome and quality of life in patients with polycystic liver disease after liver or combined liver‐kidney transplantation , 2006, Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society.

[25]  A. Chapman,et al.  Volume progression in autosomal dominant polycystic kidney disease: the major factor determining clinical outcomes. , 2005, Clinical journal of the American Society of Nephrology : CJASN.

[26]  N. LaRusso,et al.  The cholangiopathies: disorders of biliary epithelia. , 2004, Gastroenterology.

[27]  K. Uryuhara,et al.  Living-donor liver transplantation for polycystic liver disease. , 2004, Transplantation.

[28]  Manabu Watanabe,et al.  Infected solitary hepatic cyst. , 2003, Journal of Nippon Medical School = Nippon Ika Daigaku zasshi.

[29]  T. Tajiri,et al.  Long‐term results of multiple minocycline hydrochloride injections for the treatment of symptomatic solitary hepatic cyst , 2003, Journal of gastroenterology and hepatology.

[30]  T. Tajiri,et al.  Infected hepatic cyst. , 2003, Hepato-gastroenterology.

[31]  T. Tajiri,et al.  Intracystic hemorrhage of a simple hepatic cyst. , 2002, Hepato-gastroenterology.

[32]  Takakuwa,et al.  Alcohol sclerotherapy of hepatic cysts: its effect in relation to ethanol concentration. , 2000, Hepatology research : the official journal of the Japan Society of Hepatology.

[33]  M. Yamaguchi,et al.  Spontaneous rupture of a nonparasitic liver cyst complicated by intracystic hemorrhage , 1999, Journal of Gastroenterology.

[34]  I. Martin,et al.  Tailoring the management of nonparasitic liver cysts. , 1998, Annals of surgery.

[35]  A. Scherzinger,et al.  Postmenopausal estrogen therapy selectively stimulates hepatic enlargement in women with autosomal dominant polycystic kidney disease , 1997, Hepatology.

[36]  T. Koperna,et al.  Nonparasitic Cysts of the Liver: Results and Options of Surgical Treatment , 1997, World Journal of Surgery.

[37]  S. Alper,et al.  Autosomal dominant polycystic kidney disease decreases anion exchanger activity. , 1997, The American journal of physiology.

[38]  T. Schmid,et al.  Treatment of hepatic cysts in the era of laparoscopic surgery , 1997, The British journal of surgery.

[39]  B. V. Van Beers,et al.  Adult polycystic liver disease: is fenestration the most adequate operation for long-term management? , 1997, Annals of surgery.

[40]  T. Tajiri,et al.  Treatment of symptomatic hepatic cyst by injection of minocycline hydrochloride , 1996 .

[41]  K. Shimanuki,et al.  Non-surgical treatment of splenic cyst, using with installation of minocycline chloride. , 1996, Fukushima journal of medical science.

[42]  O. Farges,et al.  Laparoscopic fenestration in polycystic liver disease , 1996, The British journal of surgery.

[43]  S. Yamashiro,et al.  Obstructive jaundice caused by non-parasitic hepatic cyst treated with percutaneous drainage and instillation of minocycline hydrochloride as a sclerosing agent. , 1996, Internal medicine.

[44]  P. Morris,et al.  Hepatic cystic disease in an adult polycystic kidney disease transplant population. , 1996, The Australian and New Zealand journal of surgery.

[45]  V. Torres,et al.  Continuous epithelial cell lines from ADPKD liver cysts exhibit characteristics of intrahepatic biliary epithelium. , 1995, The American journal of physiology.

[46]  P. Morel,et al.  Surgery for adult polycystic liver disease. , 1995, Surgery.

[47]  H. Togashi,et al.  Treatment of symptomatic hepatic cysts by percutaneous instillation of minocycline hydrochloride , 1994, Digestive Diseases and Sciences.

[48]  S. Shay,et al.  Alcohol sclerosis for polycystic liver disease and obstructive jaundice: use of a nasobiliary catheter. , 1994, The American journal of gastroenterology.

[49]  H. Kawasaki,et al.  Effects of topical instillation of minocycline hydrochloride on cyst size and renal function in polycystic kidney disease. , 1993, Clinical nephrology.

[50]  K. Suzuki,et al.  Successful treatment of a hepatic cyst by one-shot instillation of minocycline chloride. , 1992, Gastroenterology.

[51]  G. Everson,et al.  Functional similarities of hepatic cystic and biliary epithelium: Studies of fluid constituents and in vivo secretion in response to secretin , 1990, Hepatology.

[52]  M. Kaplan,et al.  Treatment of recurrent thyroid cysts by injection of tetracycline or minocycline. , 1989, Archives of internal medicine.

[53]  R. Andersson,et al.  Hemoperitoneum After Spontaneous Rupture of Liver Tumor: Results of Surgical Treatment , 1988, HPB surgery : a world journal of hepatic, pancreatic and biliary surgery.

[54]  W. J. Bean,et al.  Hepatic cysts: treatment with alcohol. , 1985, AJR. American journal of roentgenology.

[55]  A. Burette,et al.  Acute hepatic injury associated with minocycline. , 1984, Archives of internal medicine.

[56]  J. Wittenberg,et al.  Percutaneous aspiration of hepatic cysts does not provide definitive therapy. , 1983, AJR. American journal of roentgenology.

[57]  R. Nelson,et al.  Treatment of symptomatic hepatic cyst by percutaneous instillation of Pantopaque. , 1976, AJR. American journal of roentgenology.

[58]  K. W. Warren,et al.  Symptomatic non‐parasitic cysts of the liver , 1974, The British journal of surgery.

[59]  H. Bolooki,et al.  Intrapleural Tetracycline for Control of Malignant Pleural Effusion: A Preliminary Report , 1972, Southern medical journal.

[60]  R. Alexander Solitary Non-Parasitic Cysts of the Liver , 1925, Edinburgh medical journal.

[61]  S. Orloff,et al.  Management of symptomatic polycystic liver disease with hepatic resection. , 2015, JAMA surgery.

[62]  E. Uchida,et al.  Biliary obstruction due to a huge simple hepatic cyst treated with laparoscopic resection. , 2011, Journal of Nippon Medical School = Nippon Ika Daigaku zasshi.

[63]  Y. Mizuguchi,et al.  Intracystic hemorrhage required no treatment from one of multiple hepatic cysts. , 2011, Journal of Nippon Medical School = Nippon Ika Daigaku zasshi.

[64]  L. van Keimpema,et al.  Polycystic liver disease: a critical appraisal of hepatic resection, cyst fenestration, and liver transplantation. , 2011, Annals of surgery.

[65]  M. Ohkawa,et al.  Percutaneous injection sclerotherapy with minocycline hydrochloride for simple renal cysts , 2007, International Urology and Nephrology.

[66]  O. Farges,et al.  Fenestration in the management of polycystic liver disease , 2004, World Journal of Surgery.

[67]  G. Frija,et al.  Symptomatic hepatic cysts: treatment with single-shot injection of minocycline hydrochloride. , 1998, Radiology.

[68]  J. Diez,et al.  Laparoscopic treatment of symptomatic cysts of the liver , 1998, The British journal of surgery.

[69]  D. Chauveau,et al.  [Liver resection in patients with polycystic liver disease]. , 1998, Gastroenterologie clinique et biologique.

[70]  V. Desmet,et al.  Ludwig symposium on biliary disorders--part I. Pathogenesis of ductal plate abnormalities. , 1998, Mayo Clinic proceedings.

[71]  H. Kawasaki,et al.  Cyst sclerotherapy with minocycline hydrochloride in patients with autosomal dominant polycystic kidney disease. , 1996, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.

[72]  L. B. Stein,et al.  Biliary obstruction due to spontaneous hemorrhage into benign hepatic cyst. , 1993, Journal of clinical gastroenterology.

[73]  J. Ludwig,et al.  The liver in autosomal dominant polycystic kidney disease. Implications for pathogenesis. , 1990, Archives of pathology & laboratory medicine.