AIM:To evaluate the factors that influence outcome of both non-invasive and invasive treatment of polycystic liver disease.METHODS:Analysis of clinical files of patients with complete follow-up from ]uly 1986 to June 2006.RESULTS:Forty-one patients (male,7;female,34),47.8 + 11.9 years age,and 5.7±6.7 years follow-up,were studied.Alkaline phosphatase (AP) elevation (25% of patients) was associated with the requirement of invasive treatment (IT,P = 0.005).IT rate was higher in symptomatic than non-symptomatic patients (65.4% vs 14.3%,P = 0.002),and in women taking hormonal replacement therapy (HRT) (P = 0.001).Cysts complications (CO) were more frequent (22%) in the symptomatic patients group (P = 0.023).Patients with body mass index (BMI) ＞ 25 (59%) had a trend to complications after IT (P = 0.075).Abdominal pain was the most common symptom (56%) and indication for IT (78%).Nineteen patients (46%) required a first IT:12 open fenestration (OF),4 laparoscopic fenestration (LF) and 3 fenestration with hepatic resection (FHR).Three required a second IT,and one required a third procedure.Complications due to first IT were found in 32% (OF 16.7%,LF 25%,FHR 66.7%),and in the second IT in 66.7% (OF 100%).Follow-up mortality rate was 0.COMCLUSlON:Presence of symptoms,elevatedAP,and CC are associated with IT requirement.HRT is associated with presence of symptoms and IT requirement.Patients with BMI ＞ 25 have a trend be susceptible to IT complications.The proportions of complications are higher in FHR and second IT groups.RS is more frequent after OF.