Faculty Collaboration Database

Surgical management of hepatocellular adenoma: take it or leave it? Ann Surg Oncol 2008 Oct;15(10):2795-803

Date

08/13/2008

Pubmed ID

18696154

DOI

10.1245/s10434-008-0090-0

Scopus ID

2-s2.0-51649090838 (requires institutional sign-in at Scopus site)   114 Citations

Abstract

BACKGROUND: Hepatocellular adenoma (HA) is a rare benign tumor of the liver. Surgical resection is generally indicated to reduce risks of hemorrhage and malignant transformation. We sought to evaluate clinical presentation, surgical management, and outcomes of patients with HA at our institution.

METHODS: We performed a retrospective review of 41 patients who underwent surgical resection for HA between 1988 and 2007.

RESULTS: Thirty-eight patients were women, and the median age at presentation was 36 years (range, 19-65 years). The most common clinical presentation was abdominal pain (70%) followed by incidental radiological finding (17%). Twenty-two patients had a history of oral contraceptive use. Median number of HA was one (range, 1-3). There were 32 open cases (3 trisectionectomy, 15 hemihepatectomy, 7 sectionectomy, 4 segmentectomy, and 3 wedge resection), and 9 laparoscopic cases (1 hemihepatectomy, 5 sectionectomy, 1 segmentectomy, and 2 wedge resection). The median estimated blood loss was 225 mL (range, 0-3400 mL). The median length of stay was 6 days (range, 1-15 days). Surgical morbidities included pleural effusion requiring percutaneous drainage (n = 2), pneumonia (n = 1), and wound infection (n = 1). There was no perioperative mortality. Twelve patients had hemorrhage from HA. Hepatocellular carcinoma was observed in two patients with HA. Median follow-up was 23 months (range, 1-194 months), at which time all patients were alive.

CONCLUSION: In view of 29% hemorrhagic and 5% malignant complication rates, we recommend surgical resection over observation if patient comorbidities and anatomic location of HA are favorable. A laparoscopic approach can be safely used in selected cases.

Author List

Cho SW, Marsh JW, Steel J, Holloway SE, Heckman JT, Ochoa ER, Geller DA, Gamblin TC

Author

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

Adenoma, Liver Cell
Adult
Aged
Female
Follow-Up Studies
Hepatectomy
Humans
Laparoscopy
Liver Neoplasms
Male
Middle Aged
Postoperative Complications
Retrospective Studies
Tomography, X-Ray Computed
Treatment Outcome