Department of General Surgery, Post Graduate Institute of Medical Education & Research, Chandigarh, India.
Pol Przegl Chir. 2021 Mar 22;93(4):28-34. doi: 10.5604/01.3001.0014.8105.
Haemangiomas are the most common benign tumours of the liver. Most of them are asymptomatic. Giant hepatic haemangioma is defined as size greater than 5 cm in diameter. The surgical treatment for giant hepatic haemangioma is not very well defined and reported. Here we analysed the treatment outcome of giant hepatic haemangiomas and redefined the nomenclature according to the size and proposing an algorithm for management of all hepatic haemangiomas.
Retrospective analyses of 6 giant hepatic haemangioma more than 10 cm in size treated by a single surgeon were included. The clinical characteristics, diagnosis, managements and outcomes were recorded. Review of literature was done for definitions, management strategies and outcome of giant haemangiomas and an algorithm was proposed.
Five patients were female and the mean age was 36.6 years (range 32 to 45). Pain abdomen was the most common symptoms (100%). Ultrasound abdomen was the initial diagnostic modality followed by contrast enhanced computed tomography. The mean size of haemangioma was 17.4cm (range 12cm to 32cm). Four patients had haemangioma in the left lobe and two had in the right lobe of liver. Formal hepatectomy was done in three patients and enucleation was done in three patients. The mean operating time was 3.66 hours (range 2.5 hours to 5 hours). The mean blood loss was 840ml (range 300ml to 1500ml). There was no surgical morbidity or mortality. On follow-up no haemangioma related complications are reported.
Giant hepatic haemangioma is mostly symptomatic. Hepatectomy and enucleation can be done without significant morbidity and mortality. There is a need for redefining the nomenclature of giant hepatic haemangiomas according to the size.
肝血管瘤是最常见的肝脏良性肿瘤。大多数肝血管瘤无症状。巨大肝血管瘤定义为直径大于 5cm 的肿瘤。巨大肝血管瘤的手术治疗尚不完全明确，报道较少。我们分析了巨大肝血管瘤的治疗结果，并根据大小重新定义了命名，并提出了一种处理所有肝血管瘤的算法。
回顾性分析了由一位外科医生治疗的 6 例直径大于 10cm 的巨大肝血管瘤患者。记录了患者的临床特征、诊断、治疗方法和结果。对文献中巨大肝血管瘤的定义、治疗策略和结果进行了复习，并提出了一种处理算法。
5 例患者为女性，平均年龄 36.6 岁（范围 32-45 岁）。腹痛是最常见的症状（100%）。腹部超声是初始诊断方法，随后是增强 CT 扫描。肝血管瘤的平均大小为 17.4cm（范围 12cm-32cm）。4 例患者的血管瘤位于左叶，2 例位于右叶。3 例患者行根治性肝切除术，3 例行肝血管瘤剜除术。平均手术时间为 3.66 小时（范围 2.5-5 小时）。平均出血量为 840ml（范围 300-1500ml）。无手术并发症或死亡。随访期间无肝血管瘤相关并发症。
巨大肝血管瘤多有症状。肝切除术和肝血管瘤剜除术可在无明显并发症和死亡率的情况下进行。需要根据大小重新定义巨大肝血管瘤的命名。
