Brouwers M A, Peeters P M, de Jong K P, Haagsma E B, Klompmaker I J, Bijleveld C M, Zwaveling J H, Slooff M J
Department of Surgery, University Hospital Groningen, The Netherlands.
Br J Surg. 1997 Mar;84(3):314-6.
The treatment of giant symptomatic haemangioma of the liver is still controversial. This retrospective study reviewed the results of surgical treatment.
Twenty-eight patients with symptomatic giant haemangioma of the liver were treated by liver resection (n = 24) or liver transplantation (n = 4). The median diameter of the haemangiomas was 11 (range 5-20) cm.
Complications occurred in five of the 24 patients treated by partial liver resection, although all survived and remain alive and well more than 2 years after surgery. In six patients there was residual haemangioma in the liver remnant which did not enlarge during the 2-year follow-up. In four patients the haemangioma was considered irresectable and liver transplantation was performed. One died after a 'two-stage' liver transplantation; the remaining three patients are alive and well, 1, 4 and 9 years after transplantation.
Liver resection is the treatment of choice for giant haemangioma of the liver where possible. In selected cases liver transplantation is indicated.
有症状的巨大肝脏血管瘤的治疗仍存在争议。本回顾性研究对手术治疗结果进行了评估。
28例有症状的巨大肝脏血管瘤患者接受了肝切除术(n = 24)或肝移植术(n = 4)。血管瘤的中位直径为11(范围5 - 20)厘米。
24例接受部分肝切除术的患者中有5例出现并发症,不过所有患者均存活,术后2年以上仍健康存活。6例患者肝残余中有残留血管瘤,在2年随访期间未增大。4例患者的血管瘤被认为无法切除,因此进行了肝移植。1例在“二期”肝移植后死亡;其余3例患者在移植后1年、4年和9年仍健康存活。
在可能的情况下,肝切除术是治疗巨大肝脏血管瘤的首选方法。在特定病例中,可考虑进行肝移植。