Faculty Collaboration Database

Surgical management of hepatic hemangiomas: a multi-institutional experience. HPB (Oxford) 2014 Oct;16(10):924-8

Date

06/20/2014

Pubmed ID

24946109

Pubmed Central ID

PMC4238859

DOI

10.1111/hpb.12291

Scopus ID

2-s2.0-84927788563 (requires institutional sign-in at Scopus site)   65 Citations

Abstract

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.

Author List

Miura JT, Amini A, Schmocker R, Nichols S, Sukato D, Winslow ER, Spolverato G, Ejaz A, Squires MH, Kooby DA, Maithel SK, Li A, Wu MC, Sarmiento JM, Bloomston M, Christians KK, Johnston FM, Tsai S, Turaga KK, Tsung A, Pawlik TM, Gamblin TC

Authors

Kathleen K. Christians MD Professor in the Surgery department at Medical College of Wisconsin
Thomas Clark Gamblin MD Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Female
Hemangioma
Hepatectomy
Hospitals, High-Volume
Humans
Liver Neoplasms
Male
Middle Aged
Postoperative Complications
Retrospective Studies
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome
Tumor Burden
United States