Abstract: Objective This study was aimed to compare the efficacy of three different minimally invasive treatments for patients with simple hepatic cysts(SHC). Methods 97 patients with SHC were admitted to our hospital between March 2021 and March 2024, and were divided into group A(n=29), B(n=33) and C(n=35), receiving intra-cystic absolute ethanol sclerotherapy, radiofrequency ablation (RFA) or polidocanol foam sclerotherapy all under ultrasound (US) guidance. Serum Golgi protein 73 (GP73), protein disulfide isomerase A3 (PDIA3) and chitinase-3-like protein 1 (CHI3L1) levels were measured by using an automatic immunoassay analyzer. Results After treatment, serum GP73, PDIA3 and CHI3L1 levels in group C were (24.4±3.6)pg/L, (67.7±5.2)ng/mL and (46.4±5.8)ng/L, all significantly lower than [(31.4±4.3)pg/L, (82.7±5.4)ng/mL and (61.8±6.4)ng/L, respectively, P<0.05] in group B or [(34.2±4.4)pg/L, (89.8±6.7)ng/mL and (66.3±6.8)ng/L, respectively, P<0.05] in group A; by end of three-month after treatment, cyst disappearance and total effectiveness rates in group C were 85.7% and 97.1%, both much higher than 58.6% and 86.2%(P<0.05) in group A, and they were 75.8% and 93.9% in group B; by end of six-month after treatment, cyst relapse in group C was 5.7%, much lower than 27.6%(P<0.05) in group A, and that was 15.2% in group B; incidence of intoxication-like reaction after alcohol injection in group A was 34.5%, while adverse effects in group B and C were much lower than in group A(P<0.05). Conclusion We strongly recommend polidocanol sclerotherapy under US guidance in dealing with patients with SHC, which could provide a best therapeutic efficacy, with higher safety.

Key words: Simple hepatic cyst, Ultrasound-guidance, Polidocanol, Absolute ethanol, Radiofrequency ablation, Therapy