Conservative and operative management of benign solid hepatic tumours: a successful stratified algorithm.

Details

Serval ID
serval:BIB_0994D94E0D43
Type
Article: article from journal or magazin.
Collection
Publications
Title
Conservative and operative management of benign solid hepatic tumours: a successful stratified algorithm.
Journal
European Journal of Gastroenterology and Hepatology
Author(s)
Dardenne S., Hubert C., Sempoux C., Annet L., Jouret-Mourin A., Horsmans Y., Van Beers B.E., Zech F., Gigot J.F.
ISSN
1473-5687 (Electronic)
ISSN-L
0954-691X
Publication state
Published
Issued date
2010
Peer-reviewed
Oui
Volume
22
Number
11
Pages
1337-1344
Language
english
Notes
Publication types: Journal Article Publication Status: ppublish
Abstract
BACKGROUND: The progress of modern imaging studies has improved the diagnostic approach of benign liver tumours, leading to a tailored approach with increased conservative management.
METHODS: One hundred and thirty-two patients suffering from benign hepatic tumours were enrolled in this study, including an operative (group I, 49 patients) and a conservative (group II, 83 patients) management. Patients' tumour and treatment features were analyzed.
RESULTS: The mean patients' age was 39 years. Indication for resection based on diagnosis of tumour nature (hepatic cell adenoma or uncertain diagnosis) and significant tumour-related abdominal pain was 15% out of 33 patients with hepatic haemangioma, 21.7% out of 60 patients with focal nodular hyperplasia and 78.4% out of 37 patients with hepatocellular adenoma. Mortality was nihil in group I. Complications and transfusion rates were related to the performance of major hepatectomy, when required for huge tumours. With a 95.5% of complete patients' follow-up during a mean of 92 months in group I and 87 months in group II, no misdiagnosis or evolution towards malignancy was encountered. Interestingly, 87.9% of all observed benign liver tumours remained stable, decreased in size or disappeared. None of the remaining lesions required surgery.
CONCLUSION: A restrictive policy of surgical management of benign liver tumours based on clinical symptoms, tumour size and nature on imaging studies (including dubious lesions) and tumour biopsies in selected cases is safe and reliable with a low-operative mortality in resected patients and satisfactory disease-control in the vast majority of observed benign liver tumours.
Keywords
Adenoma, Liver Cell/diagnosis, Adenoma, Liver Cell/surgery, Adult, Algorithms, hic" UI="D001530">Belgium, Biopsy, Chi-Square Distribution, Critical Pathways, Female, Focal Nodular Hyperplasia/diagnosis, Focal Nodular Hyperplasia/surgery, Hemangioma/diagnosis, Hemangioma/surgery, Hepatectomy/adverse effects, Humans, Laparoscopy/adverse effects, Liver Neoplasms/diagnosis, Liver Neoplasms/surgery, Magnetic Resonance Imaging, Male, Middle Aged, Patient Selection, Retrospective Studies, Time Factors, Tomography, X-Ray Computed, Treatment Outcome
Pubmed
Web of science
Create date
29/01/2015 12:42
Last modification date
20/08/2019 12:31
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