Abstract
Surgical indications for liver hemangioma remain unclear. Of 510 patients undergoing surgical resection for liver hemangioma in 118 Japanese centers between 1998 and 2012, abdominal symptoms, diagnostic accuracy, and surgical outcomes were analyzed to propose size-based surgical indications. Patients were classified into four groups based on tumor size: Group A ≤5 cm (n = 122, 24%), Group B 5-10 cm (n = 164, 32%), Group C 10-15 cm (n = 124, 24%), and Group D >15 cm (n = 100, 20%). Hemangiomas in Group A were most frequently diagnosed as malignant tumors (43.5%) due to the absence of typical imaging findings and with highest incidence of positive HBV (15.7%). Diagnostic accuracy was 98.4% in Groups B to D. Liver failure after hepatectomy was higher in Group D than in Groups A to C (3.0% vs. 0.5%, P = 0.02). Only one operative death was observed (0.2%) in Group D. In patients with ≤5 cm hemangioma, surgical resection can be indicated when a malignant tumor cannot be ruled out. However, surgery for 5-10 cm asymptomatic hemangiomas should be limited. Experienced hepatic surgeons should conduct hepatectomy for tumors >15 cm to avoid serious morbidity or mortality.
References
Jul 1, 1975·The Medical Clinics of North America·K G Ishak, L Rabin
Oct 1, 1995·Radiology·P C FreenyT C Winter
Jan 1, 1995·World Journal of Surgery·O FargesH Bismuth
Sep 28, 2001·Archives of Surgery·T TerkivatanJ N IJzermans
Sep 26, 2002·The British Journal of Surgery·T TerkivatanJ N M IJzermans
Aug 30, 2003·Journal of the American College of Surgeons·Sam S YoonRonald P DeMatteo
Jul 27, 2004·Annals of Surgery·Daniel DindoPierre-Alain Clavien
Apr 9, 2005·Journal of Clinical Gastroenterology·Bo Yoon Choi, Mindie H Nguyen
Oct 5, 2007·Journal of Gastroenterology and Hepatology·Deha ErdoganThomas M van Gulik
Sep 25, 2008·Seminars in Liver Disease·Paulette Bioulac-SageCharles Balabaud
Oct 29, 2010·Journal of the American College of Surgeons·Thomas SchnelldorferDavid M Nagorney
Jan 18, 2011·Surgery·Nuh N RahbariJürgen Weitz
Feb 15, 2011·Surgery·Moritz KochJürgen Weitz
Jul 19, 2011·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Nuh N RahbariJürgen Weitz
Jul 29, 2011·Journal of Hepato-biliary-pancreatic Sciences·Marcello DonatiKarl J Oldhafer
Aug 5, 2011·Gut and Liver·Hui JiangYong Zeng
Jan 29, 2013·World Journal of Surgery·Süleyman YedibelaAristotelis Perrakis
Aug 15, 2013·Seminars in Liver Disease·Laurence Chiche, Jean-Philippe Adam
Jun 20, 2014·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·John T MiuraT Clark Gamblin
Aug 28, 2015·Medicine·Wei ZhangXiao-Ping Chen
Citations
Jan 5, 2018·Surgical Case Reports·Tatsunori MiyataHideo Baba
Jan 15, 2020·World Journal of Gastroenterology : WJG·Monica LeonSalim Surani
Jun 12, 2020·World Journal of Surgical Oncology·Wei Long CaiShu You Peng
Feb 21, 2019·Cardiovascular and Interventional Radiology·Alicia FurumayaThomas M van Gulik
Aug 5, 2020·Surgical Case Reports·Shun-Ichi AriizumiMasakazu Yamamoto
Apr 3, 2019·Surgical Case Reports·Yuichiro OkumuraYuichiro Doki
Dec 19, 2020·The Surgery Journal·Gunjan DesaiPrasad Wagle
Apr 10, 2021·BMC Surgery·Qing-Song XieFu-Bao Liu
Oct 3, 2020·Visceral Medicine·Karl J OldhaferKim Caroline Wagner