Efficacy of Minocycline Hydrochloride Aspiration Sclerotherapy for Symptomatic Simple Hepatic Cysts: Does Clinical Outcome Vary With the Number of Injections?

Background and aim Minocycline hydrochloride (MINO) aspiration sclerotherapy has been reported as a therapeutic strategy for symptomatic simple hepatic cysts. However, treatment methods vary between studies, and the optimal frequency of MINO administration remains debated. This study aimed to compare the efficacy and safety of single-dose versus multiple-dose MINO aspiration sclerotherapy for symptomatic simple hepatic cysts, with clearly defined primary and secondary clinical outcomes. Methods This was a single-center retrospective study. Patients who underwent MINO aspiration sclerotherapy for symptomatic simple hepatic cysts at Fujigaoka Hospital from January 2017 to March 2023 were included. Participants were categorized into single- and multiple-dose MINO groups for comparison. Before admission, patients were informed of their respective treatment schedules by their attending physicians, and the number of MINO doses administered was determined as either a single or multiple doses. Results The single- and multiple-dose groups comprised five and eight cases, respectively. Clinical success rates were 80% (4/5) and 87.5% (7/8) in the single- and multiple-dose groups, respectively. The median cyst volume reduction rate was 96.5% (range, 93.0-99.1%) and 99.1% (range, 80.7-99.8%) in the single- and multiple-dose groups, respectively. Symptom disappearance rates were 80% (4/5) and 100% (8/8) in the single- and multiple-dose groups, respectively, with no significant difference. Adverse event (AE) rates were 60% (3/5) and 62.5% (5/8) in the single- and multiple-dose groups, respectively, with no statistically significant difference detected. The single-dose group tended to have a shorter median length of hospital stay (18 vs. 23 days); however, this difference was not significant. Conclusions Although the sample size was small, single-dose minocycline therapy showed outcomes that were not clearly inferior to those of multiple-dose treatment. It may also reduce AEs and shorten hospitalization, but larger studies are needed to confirm these findings. A single-dose regimen could be considered a treatment option in selected patients.