title: Outcomes of liver resection for haemorrhagic hepatocellular adenoma.
abstract: BACKGROUND
  Intratumoral bleeding and/or intraperitoneal rupture occurs in up to 20% of patients with hepatocellular adenoma (HCA). Hepatectomy in the presence of haemorrhagic HCA has been associated with increased morbidity and mortality rates. This study evaluates the outcomes of hepatectomy for haemorrhagic HCA at a single institution.
  
  
  METHODS
  Between January 1997 and December 2012, 52 consecutive patients underwent liver resection for HCA. Among them, 14 patients were resected for haemorrhagic (H)-HCAs (including 9 cases of intratumoural bleeding and 5 cases of intraperitoneal bleeding) and 38 for non-haemorrhagic (NH)-HCAs.
  
  
  RESULTS
  The preoperative characteristics were similar between the two groups except for younger age (p = .001) and shorter duration of hormonal use (p = .001) in (H)-HCAs. There were no mortalities. Intraoperative blood loss, transfusion rate, and postoperative morbidity were comparable between the two groups of patients (p = ns). The length of hospital stay was significantly longer in (H)-HCAs (p = .03). In all the resected H-HCAs, pathology showed central haemorrhagic changes with tumoral cells at the periphery of the lesions.
  
  
  CONCLUSIONS
  Liver resection for H- and NH-HCAs can be achieved with no mortality and comparable short-term outcomes.
authors.affiliation: Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Pôle des Pathologies Digestives, Hépatiques et de la Transplantation, Hôpital de Hautepierre-Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, Strasbourg, France. Electronic address: pietroad@hotmail.com.
authors.forename: Pietro
authors.initials: P
authors.lastname: Addeo
authors.affiliation: Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Pôle des Pathologies Digestives, Hépatiques et de la Transplantation, Hôpital de Hautepierre-Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, Strasbourg, France.
authors.forename: Manuela
authors.initials: M
authors.lastname: Cesaretti
authors.affiliation: Department of Surgery, The Permanente Medical Group, Kaiser Medical Center Walnut Creek, CA, USA.
authors.forename: Pascal
authors.initials: P
authors.lastname: Fuchshuber
authors.affiliation: Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Pôle des Pathologies Digestives, Hépatiques et de la Transplantation, Hôpital de Hautepierre-Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, Strasbourg, France.
authors.forename: Serena
authors.initials: S
authors.lastname: Langella
authors.affiliation: Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Pôle des Pathologies Digestives, Hépatiques et de la Transplantation, Hôpital de Hautepierre-Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, Strasbourg, France.
authors.forename: Gael
authors.initials: G
authors.lastname: Simone
authors.affiliation: Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Pôle des Pathologies Digestives, Hépatiques et de la Transplantation, Hôpital de Hautepierre-Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, Strasbourg, France.
authors.forename: Elie
authors.initials: E
authors.lastname: Oussoultzoglou
authors.affiliation: Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Pôle des Pathologies Digestives, Hépatiques et de la Transplantation, Hôpital de Hautepierre-Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, Strasbourg, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Bachellier
mesh_terms: D018248:Adenoma, Liver Cell / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D016063:Blood Loss, Surgical; D001803:Blood Transfusion; D005260:Female; D006474:Hemorrhagic Disorders / Q000601:surgery*; D006498:Hepatectomy / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013997:Time Factors; D055815:Young Adult
keywords: Haemorrhage; Hepatectomy; Hepatocellular adenoma; Liver resection; Outcomes; Tumoral rupture