Liver Haemangioma

Abstract

Aim: Hepatic haemangiomas (HHs) are the most common benign hepatic tumors. Elective surgery for giant HHs is still controversial. The aim of this retrospective study is an analysis of risk factors associated with the surgical treatment of HHs and the resulting postoperative complications.Materials and Methods: Forty-two patients underwent surgery for giant HHs at the Naval Hospital, Varna, Bulgaria between January, 2001 and December, 2014. Clinical presentation, diagnosis, treatment, and postoperative complications were analyzed.Results: Forty-one patients (97.6%) underwent elective surgery while in 1(2.4%) patient an emergency right hemihepatectomy had to be performed because of a ruptured haemangioma. The major indication for elective removal of HHs is abdominal pain. A total of 24 (57.1%) major liver resections and 18 (42.8%) enucleations were performed. Five patients had complications, including a biloma (n=2), a liver abscess (n=1), postoperative bleeding (n=1), and a wound infection (n=1). Resection and enucleation were both relatively safe with an acceptable complication rate (11.9%) and there was no mortality. The complication rates for enucleation and resection were 5.5% (1/18) and 16.6% (4/24), respectively, but the difference was not statistically significant (p=0.623). Clinical features including large tumor size (p=0.011), symptomatic tumors (p=0.013), increased blood loss (p=0.035), and prolonged operative time (p=0.005), indicating higher risks, were associated with an increase in the postoperative complications.Conclusion: Recent advances in surgical techniques and established perioperative management have now made it possible to perform liver resection or enucleation safely in most specialized units. Identifying the discriminatory factors that predict postoperative complications are important in establishing effective strategies for surgical procedures.