BACKGROUND: As the morbidity and mortality rates associated with emergency resection in patients with a ruptured hepatocellular adenoma are high, the authors have favoured initial non-operative management in haemodynamically stable patients. METHODS: A retrospective study was performed to evaluate the treatment of ruptured hepatocellular adenoma. RESULTS: Over a 21-year interval, 12 patients presented with a ruptured hepatocellular adenoma. Haemodynamic observation and support was the initial management in all 12 patients. Three underwent urgent laparotomy and gauze packing because of haemodynamic instability; no emergency liver resection was necessary. Eight patients had definitive surgery; three developed postoperative complications but none died. Regression of the tumour was observed in three of four patients treated conservatively. CONCLUSION: The initial management of a ruptured hepatocellular adenoma should be haemodynamic stabilization. Definitive resection is required for rebleeding or for tumours exceeding 5 cm in diameter. A conservative approach may well be justified in case of regression of an asymptomatic adenoma.
BACKGROUND: As the morbidity and mortality rates associated with emergency resection in patients with a ruptured hepatocellular adenoma are high, the authors have favoured initial non-operative management in haemodynamically stable patients. METHODS: A retrospective study was performed to evaluate the treatment of ruptured hepatocellular adenoma. RESULTS: Over a 21-year interval, 12 patients presented with a ruptured hepatocellular adenoma. Haemodynamic observation and support was the initial management in all 12 patients. Three underwent urgent laparotomy and gauze packing because of haemodynamic instability; no emergency liver resection was necessary. Eight patients had definitive surgery; three developed postoperative complications but none died. Regression of the tumour was observed in three of four patients treated conservatively. CONCLUSION: The initial management of a ruptured hepatocellular adenoma should be haemodynamic stabilization. Definitive resection is required for rebleeding or for tumours exceeding 5 cm in diameter. A conservative approach may well be justified in case of regression of an asymptomatic adenoma.
Authors: Mohammed Abu Hilal; Francesco Di Fabio; Robert David Wiltshire; Mohammed Hamdan; David M Layfield; Neil William Pearce Journal: World J Gastrointest Surg Date: 2011-07-27
Authors: Luis Eduardo Veras Pinto; João Paulo Ribeiro Silva; Gustavo Coêlho Rêgo; José Huygens Parente Garcia Journal: Arq Bras Cir Dig Date: 2015 Nov-Dec
Authors: Ser Yee Lee; T Peter Kingham; Maria D LaGratta; Jose Jessurun; Daniel Cherqui; William R Jarnagin; Michael D Kluger Journal: HPB (Oxford) Date: 2015-12-11 Impact factor: 3.647