Giant cavernous liver hemangiomas: effect of operative approach on outcome.
OBJECTIVE
The choice of operative technique for resection of giant cavernous hepatic hemangiomas has an effect on outcome.


METHODS
Case series.


METHODS
Tertiary hepatobiliary surgery-liver transplantation service.


METHODS
Fifty-two adult patients who underwent resection of symptomatic hepatic hemangiomas (38 [73%] in the right lobe; average diameter, 10.9 cm) by means of lobectomy or enucleation, with or without Pringle inflow occlusion.


METHODS
Blood transfusion, morbidity, mortality, and length of hospitalization.


RESULTS
Patient age and sex and the size of hemangiomas were similar for patients who underwent lobectomy and enucleation. Right-lobe lesions were more often treated by enucleation, and inflow occlusion was used more frequently; transfusion requirements and length of hospitalization were similar for both techniques. Complications were more frequent after lobectomy. There were no deaths. In the latter years of the series, enucleation was used in 22 (63%) and inflow occlusion in 24 (69%) of 35 patients.


CONCLUSIONS
Outcome is related to the operative approach used for resection of giant cavernous liver hemangiomas. Although lobectomy and enucleation are curative, enucleation offers greater preservation of normal hepatic parenchyma and fewer complications and is the preferred technique for suitable lesions.
Department of Surgery, Pennsylvania State Milton S. Hershey Medical Center, Hershey, USA.
Susan M
SM
Lerner
Jonathan R
JR
Hiatt
Johanna
J
Salamandra
Pauline W
PW
Chen
Douglas G
DG
Farmer
Rafik M
RM
Ghobrial
Ronald W
RW
Busuttil
D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D005260:Female; D006392:Hemangioma, Cavernous / Q000601:surgery*; D006801:Humans; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D013514:Surgical Procedures, Operative / Q000379:methods*; D016896:Treatment Outcome