Symptomatic Giant Cavernous Haemangioma of the Liver: Is Enucleation a Safe Method?

Demiryürek, Haluk; Alabaz, Ömer; D, Agdemir; Sungur, Ilhan; Erkoçak, Emin; Akınoğlu, Alper; Alparslan, Ali H.; Zorludemir, Suzan

doi:10.1155/1997/53453

Cited by 12 publications

(8 citation statements)

References 13 publications

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“…Similar to our experience, others have found it to result in less blood loss (400-922 ml) and require less operating time (204 min) compared to liver resection (blood loss 1000-2080 ml; operation time 258-262 min). 10,[12][13][14] Zimmermann and Baer 15 described the well-formed tumour-liver interface and its surgical application. Since there are no bile ducts traversing the plane between the liver and the haemangioma, enucleation does not result in postoperative bile leak, which is an infrequent, but troublesome, complication of liver resection.…”

Section: Discussionmentioning

confidence: 99%

Giant Haemangioma of the Liver: Is Enucleation Better than Resection?

Singh

Kapoor

Sahni

et al. 2007

annals

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Ann R Coll Surg Engl 2007; 89: 490-493 490Haemangioma is the commonest benign liver tumour with an incidence of 0.4-7.3% in autopsy series. 1 With the increasing use of imaging modalities, asymptomatic giant haemangiomas (> 4 cm in size) are detected more frequently. These lesions can, at times, present a diagnostic dilemma. 2There is considerable controversy regarding the ideal treatment of giant haemangiomas of the liver. Some authors, on the basis of long-term follow-up of such lesions, propose that most of these lesions do not require any treatment. 3,4 Others have treated these lesions surgically, citing symptoms of the patient, increase in size and an occasional case of rupture, or diagnostic uncertainty. 5The surgical procedure is the choice of the individual surgeon -the commonest being enucleation and resection. 5,6 Massive blood loss can occur during surgery and may result in an operative mortality. Though liver resections can be safely accomplished in specialised units, occasional postoperative complications (bile leak) do occur. Enucleation may represent a safer surgical option with fewer complications for the treatment of haemangiomas, especially in centres with limited experience in liver resections.We reviewed our experience of the surgical treatment of giant haemangiomas of the liver with regard to presentation, indications and outcome. We also compared our results with those published in the literature. Patients and MethodsThe details of all patients undergoing surgical treatment of liver haemangiomas at the Department of Gastrointestinal There is continuing debate regarding the ideal method of surgical treatment for liver haemangiomas, with some surgeons favouring enucleation over liver resection.

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Section: Discussionmentioning

confidence: 99%

Giant Haemangioma of the Liver: Is Enucleation Better than Resection?

Singh

Kapoor

Sahni

et al. 2007

annals

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“…In 1988, Alper et al [9] first described enucleation, which is based on the macroscopic observation that hemangiomas are encapsulated by a dissection plane between the liver parenchyma and the hemangioma [10]. Most authors advocated enucleation because it is safer and quicker, with fewer overall complications and less blood loss [6,11,12,13], while others concluded that results were similar between enucleation and anatomic resection [14,15].…”

Section: Introductionmentioning

confidence: 99%

Enucleation versus Anatomic Resection for Giant Hepatic Hemangioma: A Meta-Analysis

Liu

Wei

Wang

et al. 2016

Gastrointest Tumors

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Background: Hepatic hemangiomas are the most common benign liver tumors, and the management of giant hepatic hemangioma (GHH) is still in controversial. The aim of this meta-analysis was to compare the postoperative outcomes of enucleation versus anatomic resection for GHH. Methods: PubMed, Embase, Web of Science, and the Cochrane Library were searched from January 1988 to December 2015 to identify studies comparing the outcomes of enucleation versus anatomic resection for GHH. Finally, we performed this meta-analysis using the Review Manager 5.3 software, and the results were presented as risk ratio (RR) or mean difference (MD) with corresponding 95% confidence interval (CI). The major limitation is that all data were derived from nonrandomized studies, and we cannot exclude potential selection bias. Results: Nine studies involving 1,185 patients were included. The results showed that there was a lower incidence of complications (RR = 0.66, 95% CI 0.52 to 0.84, I² = 0%, p = 0.0007); no incidents of death occurred among the 9 included trials. Blood loss (MD = -419.07 mL, 95% CI -575.04 to -263.09, I² = 83%, p < 0.00001), duration of surgery (MD = -23.5 min, 95% CI -45.28 to -1.74, I² = 0%, p = 0.03), and length of hospital stay (MD = -1.59 days, 95% CI -3.06 to -0.13, I² = 0%, p = 0.03) were much lower in the enucleation group. Conclusions: GHH can be removed safely by either enucleation or anatomic resection. Enucleation can preserve more hepatic parenchyma and reduce postoperative complications, which is why it should be the preferred surgical procedure for suitable lesions.

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“…Simple enucleating has been reported to be safe without major blood loss. 4,9 Surgical resection is the treatment of choice for a giant symptomatic hemangioma, and if it is unresectable, then liver transplantation may be considered. 10 Our experience indicates that resection of giant hemangioma of the liver is safe.…”

Section: Discussionmentioning

confidence: 99%

Experience with Surgical Resection of Giant Hepatic Hemangiomas

Sebayel

2000

Ann Saudi Med

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Symptomatic Giant Cavernous Haemangioma of the Liver: Is Enucleation a Safe Method?

Cited by 12 publications

References 13 publications

Giant Haemangioma of the Liver: Is Enucleation Better than Resection?

Giant Haemangioma of the Liver: Is Enucleation Better than Resection?

Enucleation versus Anatomic Resection for Giant Hepatic Hemangioma: A Meta-Analysis

Experience with Surgical Resection of Giant Hepatic Hemangiomas

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