Hepatectomy for hemangioma; safe, but is it successful?

BACKGROUND/AIMS: Large hepatic hemangiomata may give rise to abdominal discomfort, prompting consultation with a hepatobiliary surgeon. The effectiveness of liver resection to treat such symptoms has varied in previously published reports. We sought to examine outcomes related to resection of hepatic hemangioma at a high-volume HPB center.

METHODOLOGY: Consecutive patients between 1995-2011 undergoing resection for a hepatic hemangioma were identified. Demographic, operative, imaging, and complication-related data were collected.

RESULTS: Fifty-four patients (41 female, 76%) underwent liver resection for hemangioma. Median age was 48 years (range: 25-80), and median lesion size was 8.0 cm (range: 1.6-25). Indications for resection included pain (28 patients, 52%), increasing size (9, 17%), patient anxiety (5, 9%), and inability to exclude malignancy (12, 22%). There were no perioperative deaths, and 16 patients (30%) had Clavien grade ≥II complications. Of the 28 patients with preoperative pain, 8 (28%) continued to report similar abdominal discomfort at a median follow-up of 10 months.

CONCLUSIONS: Liver resection for hemangiomata can be performed safely, albeit with significant morbidity. The majority of patients,but not all, have pain relief following hepatic resection.A cautious approach should be taken when evaluating patients for hemangioma resection.