[Two steps liver resection with right portal vein ligation for two giant hemangiomas of the left and right lobes].
The liver failure is one of the most life threatening complication after extensive liver resections. In resections that exceed 70% of liver parenchyma, a two steps approach with portal branch ligation is the best alternative. The aim of the paper is to present the management of a 65-year-old female admitted into hospital for two giant symptomatic liver hemangiomas in the left lobe: segment III-20 cm. and in the right lobe: segments V-VIII-19 cm, which were non-resectable in the same intervention because the small amount of liver parenchyma left, and for these we decided a two steps surgery: left atypical resection with right portal vein ligation in the first step, attending 4 month for atrophy-hypertrophy process, and then right typical hepatectomy for second hemangioma who practically occupied all right liver. The postoperative course, was favorable after both interventions, with 7 days postsurgery hospitalisation, despite some hepatic failure symptoms: coagulation disturbance, increasing of bilirubin and ALAT, ASAT levels, ascites.
Moldovan
B
B
Clinica Chirurgie I, Tg-Mureş, Spitalul Clinic Judeţean de Urgenţa, Tg-Mureş. moldovanb@hotmail.com
Copotoiu
C
C
Bud
V
V
Toma
L
L
Ghiţescu
Ioana
I
Grigorescu
Bianca
B
Serac
G
G
Munteanu
Mihaela
M
D000368:Aged; D005260:Female; D006392:Hemangioma, Cavernous / Q000000981:diagnostic imaging / Q000601:surgery*; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008026:Ligation; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D011169:Portal Vein / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome