Farges O, Daradkeh S, Bismuth H
Hepato-Biliary Surgery and Liver Transplant Unit, Paul Brousse Hospital, Villejuif, France.
World J Surg. 1995 Jan-Feb;19(1):19-24. doi: 10.1007/BF00316974.
A total of 163 patients with cavernous hemangiomas of the liver were managed at Paul Brousse Hospital between 1970 and 1992. The tumor was smaller than 4 cm in 54 patients and larger than 10 cm in 38 patients. The diagnostic sensitivities of the imaging procedures were as follows: ultrasonography 61%; angio-computed tomography scanning 77%; angiography 85%; magnetic resonance imaging 92%. The tumor was diagnosed during the evaluation of abdominal pain in 87 patients. Forty-seven patients had associated disorders that proved to be responsible for the symptoms. Fourteen patients with incapacitating symptoms underwent specific treatment of their tumor: resection (n = 8), embolization (n = 5), or hepatic artery ligation (n = 1). Seven of these patients are still symptomatic, indicating that the hemangioma was in fact not responsible for their symptoms. Twenty-five patients were given oral analgesic medications; in 21 the symptoms diminished or became infrequent. Unresected hemangiomas did not significantly increase in size, nor have they become complicated or symptomatic. These results indicate that resection of liver hemangiomas is rarely required, and such treatment should be carefully balanced against the risk inherent in liver surgery.
1970年至1992年间，保罗·布罗斯医院共收治了163例肝海绵状血管瘤患者。肿瘤小于4 cm的患者有54例，大于10 cm的患者有38例。各成像检查方法的诊断敏感性如下：超声检查为61%；血管计算机断层扫描为77%；血管造影为85%；磁共振成像为92%。87例患者在评估腹痛期间确诊肿瘤。47例患者伴有其他疾病，这些疾病被证实是导致症状的原因。14例有失能症状的患者接受了针对肿瘤的特异性治疗：手术切除（n = 8）、栓塞（n = 5）或肝动脉结扎（n = 1）。这些患者中有7例仍有症状，这表明血管瘤实际上并非其症状的病因。25例患者服用了口服镇痛药；其中21例症状减轻或发作频率降低。未切除的血管瘤大小未显著增加，也未出现并发症或症状。这些结果表明，肝血管瘤很少需要手术切除，这种治疗应与肝脏手术固有的风险仔细权衡。
