Moreno González E, Landa Garcia I, Calleja Kempin J, Santoyo Santoyo J, Gomez Gutierrez M, Jover Navalón J M, Arias Diaz J, Manrique A, Vorwald Kuborn P
Abteilung für Magen-Darm-Chirurgie II, Ciudad Sanitaria 1 de Octubre,Madrid.
Chirurg. 1988 May;59(5):338-42.
Over a period of 6.5 years, 29 patients with liver hemangiomas have been examined. In 8 patients, the most frequent symptom was pain; in 11, a tumor was found. The diagnosis was made by means of scintigraphy with 99mTc, followed by real-time sonography, computed tomography using a contrast medium, and selective arteriography. In 16 patients (15 women, 1 man), the tumor radius was more than 6 cm and in 9 of these, more than 10 cm. In 3 patients, a left lobectomy was carried out, and in 5 a right lobectomy; in an additional 5 patients, a extended right lobectomy (three segments excised) was done. In the rest, a medial lobectomy, a segmentectomy on the left side, or a segmentectomy on the right was performed. The only complications observed in the whole series were: pleural effusion (1 case), subphrenic abscess (1), and transitory biliary fistula (1). All hemangiomas with a radius of more than 10 cm should be removed operatively, as should smaller symptomatic hemangiomas and tumors that are not clearly benign.
在6.5年的时间里,对29例肝血管瘤患者进行了检查。8例患者最常见的症状是疼痛;11例发现有肿瘤。诊断通过99mTc闪烁扫描进行,随后进行实时超声检查、使用造影剂的计算机断层扫描以及选择性动脉造影。16例患者(15名女性,1名男性)肿瘤半径超过6 cm,其中9例超过10 cm。3例患者进行了左叶切除术,5例进行了右叶切除术;另外5例患者进行了扩大右叶切除术(切除三个节段)。其余患者进行了中叶切除术、左侧节段切除术或右侧节段切除术。整个系列中观察到的唯一并发症为:胸腔积液(1例)、膈下脓肿(1例)和暂时性胆瘘(1例)。所有半径超过10 cm的血管瘤均应手术切除,较小的有症状血管瘤以及不能明确为良性的肿瘤也应如此。