Abstract: Objective To compare the therapeutic efficacy of ultrasound-guided percutaneous aspiration combined with anhydrous ethanol or lauromacrogol sclerotherapy in patients with giant simple hepatic cysts (GSHC). Methods A total of 94 patients with GSHC treated between January 2022 and December 2024 in Lingbi People′s Hospital were enrolled. According to the sclerosing agent used, patients were assigned to the absolute ethanol group (n=52) or the lauromacrogol group (n=42). The cyst volume reduction rate, systemic stress response indicators, and adverse events were compared between the two groups. Results At 1, 3, and 6 months after treatment, the cyst volume reduction rates in the lauromacrogol group were (67.0±8.6)%, (82.6±7.8)%, and (93.8±7.0)%, respectively, all significantly higher than those in the absolute ethanol group [(55.4±7.1) %, (74.5±6.3) %, and (84.3±6.5) %, P<0.05]. One week after treatment, NE, glu, and lactate levels in the absolute ethanol group increased to (405.8±54.5) pg/mL, (6.2±0.8) mmol/L, and (2.1±0.5) mmol/L, respectively, with greater elevations than those observed in the lauromacrogol group [(366.5±46.2) pg/mL, (5.5±0.6) mmol/L, and (1.8±0.4) mmol/L, P<0.05]. The incidence of adverse reactions in the absolute ethanol group was 30.8% (15/52), significantly higher than that in the lauromacrogol group [9.5% (4/42), P<0.05]. Conclusion Ultrasound-guided lauromacrogol sclerotherapy for GSHC provides superior cyst volume reduction, milder systemic and local inflammatory stress responses, and better safety compared with anhydrous ethanol, making it a preferred option in clinical practice, particularly for high-risk patients.

Key words: Simple hepatic cyst, Absolute ethanol, Lauromacrogol, Stress markers, Inflammatory cytokines