Jung Jin-Min, Hwang Shin, Kim Ki-Hun, Ahn Chul-Soo, Moon Deok-Bog, Ha Tae-Yong, Song Gi-Won, Jung Dong-Hwan
Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Ann Hepatobiliary Pancreat Surg. 2019 Feb;23(1):8-12. doi: 10.14701/ahbps.2019.23.1.8. Epub 2019 Feb 28.
BACKGROUNDS/AIMS: Focal nodular hyperplasia (FNH) is one of the most common benign tumors of the liver. There is still a lack of evidence on surgical indications for FNH. This study intended to analyze the surgical indications for FNH.
We analyzed 48 cases of FNH diagnosed after hepatic resection.
Common reasons leading to surgical resection were diagnostic uncertainty (n=31), and persistent symptoms (n=8). None of our patients had a past history of contraceptive use. Percutaneous biopsy was performed in 14 patients and FNH was diagnosed in nine patients, and hepatic adenoma, hepatocellular carcinoma, plasmacytoma, angiosarcoma, and atypical hepatocellular proliferation in one patient each. Minor hepatectomy (n=37) was performed more frequently than major hepatectomy (n=11). Open hepatectomy (n=29) was performed more frequently than laparoscopic hepatectomy (n=19), but laparoscopic and minimally-invasive surgery was frequently performed during the late phase of the study period. Postoperative surgical complications occurred in two patients (4.1%).
FNH can be diagnosed by imaging studies, but surgical treatment may be considered in cases of diagnostic uncertainty or persistent symptoms.
背景/目的:局灶性结节性增生(FNH)是最常见的肝脏良性肿瘤之一。目前仍缺乏关于FNH手术指征的证据。本研究旨在分析FNH的手术指征。
我们分析了48例肝切除术后诊断为FNH的病例。
导致手术切除的常见原因是诊断不明确(n = 31)和症状持续(n = 8)。我们的患者均无既往避孕药使用史。14例患者进行了经皮活检,其中9例诊断为FNH,1例分别诊断为肝腺瘤、肝细胞癌、浆细胞瘤、血管肉瘤和非典型肝细胞增生。小范围肝切除术(n = 37)比大范围肝切除术(n = 11)更常用。开腹肝切除术(n = 29)比腹腔镜肝切除术(n = 19)更常用,但在研究后期腹腔镜及微创手术的应用更为频繁。2例患者(4.1%)发生了术后手术并发症。
FNH可通过影像学检查诊断,但在诊断不明确或症状持续的情况下可考虑手术治疗。