SURGICAL TREATMENT OF HEPATIC HAEMANGIOMAS: A 15-YEAR EXPERIENCE

Authors

  • Stavros Gourgiotis,

    Corresponding author
    1. * Division of General Surgery and Oncology, Royal Liverpool Hospital, Liverpool, UK; and Department of Surgery, Athens Medical Centre, and § First Surgical Department, ‘Evangelismos’ General Hospital of Athens, Athens, and Department of Obstetrics and Gynecology, University Hospital of Larissa, and Patsidis Private General Hospital of Larissa, Larissa, Greece
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  • Panagiotis Moustafellos,

    1. * Division of General Surgery and Oncology, Royal Liverpool Hospital, Liverpool, UK; and Department of Surgery, Athens Medical Centre, and § First Surgical Department, ‘Evangelismos’ General Hospital of Athens, Athens, and Department of Obstetrics and Gynecology, University Hospital of Larissa, and Patsidis Private General Hospital of Larissa, Larissa, Greece
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  • Apostolos Zavos,

    1. * Division of General Surgery and Oncology, Royal Liverpool Hospital, Liverpool, UK; and Department of Surgery, Athens Medical Centre, and § First Surgical Department, ‘Evangelismos’ General Hospital of Athens, Athens, and Department of Obstetrics and Gynecology, University Hospital of Larissa, and Patsidis Private General Hospital of Larissa, Larissa, Greece
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  • Nikitas Dimopoulos,

    1. * Division of General Surgery and Oncology, Royal Liverpool Hospital, Liverpool, UK; and Department of Surgery, Athens Medical Centre, and § First Surgical Department, ‘Evangelismos’ General Hospital of Athens, Athens, and Department of Obstetrics and Gynecology, University Hospital of Larissa, and Patsidis Private General Hospital of Larissa, Larissa, Greece
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  • Christina Vericouki,

    1. * Division of General Surgery and Oncology, Royal Liverpool Hospital, Liverpool, UK; and Department of Surgery, Athens Medical Centre, and § First Surgical Department, ‘Evangelismos’ General Hospital of Athens, Athens, and Department of Obstetrics and Gynecology, University Hospital of Larissa, and Patsidis Private General Hospital of Larissa, Larissa, Greece
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  • Evangelos I. Hadjiyannakis

    1. * Division of General Surgery and Oncology, Royal Liverpool Hospital, Liverpool, UK; and Department of Surgery, Athens Medical Centre, and § First Surgical Department, ‘Evangelismos’ General Hospital of Athens, Athens, and Department of Obstetrics and Gynecology, University Hospital of Larissa, and Patsidis Private General Hospital of Larissa, Larissa, Greece
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  • P. Moustafellos MD; N. Dimopoulos MD; A. Zavos MD; C. Vericouki MD; E. Hadjiyannakis MD.

Dr Stavros Gourgiotis, Division of General Surgery and Oncology, Royal Liverpool Hospital, Liverpool L69 3GA, UK.
Email: drsgourgiotis@tiscali.co.uk

Abstract

Background:  Hepatic haemangiomas are congenital vascular malformations. They are the most common benign tumours of the liver and are often asymptomatic. Spontaneous or traumatic rupture, intratumoral bleeding, consumption coagulopathy and rapid growth are the mandatory surgical indications. We present our experience over the last 15 years with the surgical management of 15 liver haemangiomas to clarify the safety and effectiveness of this treatment.

Methods:  There were 15 patients with hepatic haemangiomas who were surgically treated from 1990 to 2004. Indications for the operation were spontaneous or traumatic rupture, consumption coagulopathy, rapid growth, abdominal pain and uncertain diagnosis. Four of these lesions were located on the left lobe, nine on the right lobe; one lesion was located on the left and the right lobes and one on segments VII and VIII. Methods for diagnosis included ultrasonography, computed tomography scan, magnetic resonance imaging and selective hepatic arteriography or combinations of more than one technique.

Results:  The procedures included five right-extended lobectomies, five right lobectomies, one left-extended lobectomy, two left lobectomies and two segmental resections. There was no death. The postoperative morbidity was minimal and was mainly correlated to two subdiaphragmatic collections, one intra-abdominal collection and one wound infection. The postoperative hospital stay was 12.7 days (range, 10–19 days). During the follow-up period, there was no recurrence.

Conclusion:  The resection of the hepatic haemangioma is safe. The indications for resection, however, should be carefully analysed before embarking on such a major operation.

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