title: Hepatocellular adenoma: an excellent indication for laparoscopic liver resection.
abstract: OBJECTIVE
  Laparoscopic resection for benign liver disease has gained wide acceptance in recent years and hepatocellular adenoma (HA) seems to be an appropriate indication. This study aimed to discuss diagnosis and treatment strategies, and to assess the feasibility, safety and outcomes of pure laparoscopic liver resection (LLR) in a large series of patients with HA.
  
  
  METHODS
  Of 88 patients who underwent pure LLR, 31 were identified as having HA. Diagnosis was based on radiological evaluation and resections were performed for lesions measuring >5.0 cm.
  
  
  RESULTS
  The sample included 29 female and two male patients. Their mean age was 33.2 years. A total of 27 patients had a single lesion, one patient had two and one had four lesions. The two remaining patients had liver adenomatosis. Mean tumour size was 7.5 cm. Three right hepatectomies, 17 left lateral sectionectomies and 11 wedge resections or segmentectomies were performed. There was no need for blood transfusion or conversion to open surgery. Postoperative complications occurred in two patients. Mean hospital stay was 3.8 days.
  
  
  CONCLUSIONS
  Hepatocellular adenoma should be regarded as an excellent indication for pure LLR. Pure LLR is safe and feasible and should be considered the standard of care for the treatment of HA when performed by surgeons with experience in liver and laparoscopic surgery.
authors.affiliation: Liver Surgery Unit, Department of Gastroenterology, University of São Paulo Medical School, São Paulo, SP, Brazil. pherman@uol.com.br
authors.forename: Paulo
authors.initials: P
authors.lastname: Herman
authors.forename: Fabricio Ferreira
authors.initials: FF
authors.lastname: Coelho
authors.forename: Marcos Vinicius
authors.initials: MV
authors.lastname: Perini
authors.forename: Renato Micelli
authors.initials: RM
authors.lastname: Lupinacci
authors.forename: Luiz Augusto Carneiro
authors.initials: LA
authors.lastname: D'Albuquerque
authors.forename: Ivan
authors.initials: I
authors.lastname: Cecconello
mesh_terms: D018248:Adenoma, Liver Cell / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D000328:Adult; D001706:Biopsy; D001938:Brazil; D005240:Feasibility Studies; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D007902:Length of Stay; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011237:Predictive Value of Tests; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D047368:Tumor Burden