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Endoscopic decompression may not relieve biliary obstruction caused by polycystic liver disease. Report of a case from malaysia
Author(s) -
Mahadeva Sanjiv,
Bux Shaik Ismail,
Goh KheanLee
Publication year - 2003
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1046/j.1443-1661.2003.00249.x
Subject(s) - medicine , endoscopic retrograde cholangiopancreatography , jaundice , polycystic liver disease , cyst , decompression , intrahepatic bile ducts , percutaneous , cholestasis , complication , radiology , surgery , gastroenterology , bile duct , liver transplantation , pancreatitis , transplantation
A 55‐year‐old man with known adult polycystic kidney and liver disease presented to us with a gradual onset of cholestatic jaundice. Gross polycystic disease was noted on liver imaging and endoscopic retrograde cholangiopancreatography (ERCP) confirmed external compression of intrahepatic bile ducts with some dilatation. Despite a well‐placed biliary stent, the jaundice continued to deteriorate until percutaneous aspiration of two of the largest cysts, followed by ethanol injection. His jaundice resolved subsequently and has not recurred to date. The merits of ERCP, biliary decompression and percutaneous cyst drainage in this rare complication of polycystic liver disease are discussed. We conclude that endoscopic biliary drainage is of little value and that cyst drainage with ethanol ablation in the initial stage should be the treatment of choice.