BACKGROUND: The management of hepatic hemangiomas remains ill defined. This study sought to investigate the indications, surgical management and outcomes of patients who underwent a resection for hepatic hemangiomas. METHODS: A retrospective review from six major liver centres in the United States identifying patients who underwent surgery for hepatic hemangiomas was performed. Clinico-pathological, treatment and peri-operative data were evaluated. RESULTS: Of the 241patients who underwent a resection, the median age was 46 years [interquartile range (IQR): 39-53] and 85.5% were female. The median hemangioma size was 8.5 cm (IQR: 6-12.1). Surgery was performed for abdominal symptoms (85%), increasing hemangioma size (11.3%) and patient anxiety (3.7%). Life-threatening complications necessitating a hemangioma resection occurred in three patients (1.2%). Clavien Grade 3 or higher complications occurred in 14 patients (5.7%). The 30- and 90-day mortality was 0.8% (n = 2). Of patients with abdominal symptoms, 63.2% reported improvement of symptoms post-operatively. CONCLUSION: A hemangioma resection can be safely performed at high-volume institutions. The primary indication for surgery remains for intractable symptoms. The development of severe complications associated with non-operative management remains a rare event, ultimately challenging the necessity of additional surgical indications for a hemangioma resection.
BACKGROUND: The management of hepatic hemangiomas remains ill defined. This study sought to investigate the indications, surgical management and outcomes of patients who underwent a resection for hepatic hemangiomas. METHODS: A retrospective review from six major liver centres in the United States identifying patients who underwent surgery for hepatic hemangiomas was performed. Clinico-pathological, treatment and peri-operative data were evaluated. RESULTS: Of the 241patients who underwent a resection, the median age was 46 years [interquartile range (IQR): 39-53] and 85.5% were female. The median hemangioma size was 8.5 cm (IQR: 6-12.1). Surgery was performed for abdominal symptoms (85%), increasing hemangioma size (11.3%) and patientanxiety (3.7%). Life-threatening complications necessitating a hemangioma resection occurred in three patients (1.2%). Clavien Grade 3 or higher complications occurred in 14 patients (5.7%). The 30- and 90-day mortality was 0.8% (n = 2). Of patients with abdominal symptoms, 63.2% reported improvement of symptoms post-operatively. CONCLUSION: A hemangioma resection can be safely performed at high-volume institutions. The primary indication for surgery remains for intractable symptoms. The development of severe complications associated with non-operative management remains a rare event, ultimately challenging the necessity of additional surgical indications for a hemangioma resection.
Authors: Peter J Kneuertz; J Wallis Marsh; Mechteld C de Jong; Keaton Covert; Omar Hyder; Kenzo Hirose; Richard D Schulick; Michael A Choti; David A Geller; Timothy M Pawlik Journal: Surgery Date: 2012-08 Impact factor: 3.982
Authors: T Terkivatan; W W Vrijland; P T Den Hoed; R A De Man; S M Hussain; H W Tilanus; J N M IJzermans Journal: Br J Surg Date: 2002-10 Impact factor: 6.939
Authors: Thomas Schnelldorfer; Adam L Ware; Rory Smoot; Cathy D Schleck; William S Harmsen; David M Nagorney Journal: J Am Coll Surg Date: 2010-10-25 Impact factor: 6.113
Authors: D G Mitchell; S Saini; J Weinreb; E E De Lange; V M Runge; J E Kuhlman; Y Parisky; C D Johnson; J J Brown; M Schnall Journal: Radiology Date: 1994-10 Impact factor: 11.105
Authors: Deha Erdogan; Olivier R C Busch; Otto M van Delden; Roelof J Bennink; Fiebo J W ten Kate; Dirk J Gouma; Thomas M van Gulik Journal: J Gastroenterol Hepatol Date: 2007-11 Impact factor: 4.029
Authors: Muthukumarassamy Rajakannu; Gerard Pascal; Denis Castaing; Eric Vibert; Christian Ducerf; Jean-Yves Mabrut; Jacques Baulieux; René Adam Journal: J Clin Exp Hepatol Date: 2020-10-02