Surgical management of hepatic hemangiomas: A multi-institutional experience

John T. Miura, Albert Amini, Ryan Schmocker, Shawnn Nichols, Daniel Sukato, Emily R. Winslow, Gaya Spolverato, Aslam Ejaz, Malcolm H. Squires, David A. Kooby, Shishir K. Maithel, Aijun Li, Meng Chao Wu, Juan M. Sarmiento, Mark Bloomston, Kathleen K. Christians, Fabian M. Johnston, Susan Tsai, Kiran K. Turaga, Allan TsungTimothy M. Pawlik, T. Clark Gamblin

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The management of hepatic hemangiomas remains ill defined. This study sought to investigate the indications, surgical management and outcomes of patients who underwent a resection for hepatic hemangiomas. Methods: A retrospective review from six major liver centres in the United States identifying patients who underwent surgery for hepatic hemangiomas was performed. Clinico-pathological, treatment and peri-operative data were evaluated. Results: Of the 241patients who underwent a resection, the median age was 46 years [interquartile range (IQR): 39-53] and 85.5% were female. The median hemangioma size was 8.5 cm (IQR: 6-12.1). Surgery was performed for abdominal symptoms (85%), increasing hemangioma size (11.3%) and patient anxiety (3.7%). Life-threatening complications necessitating a hemangioma resection occurred in three patients (1.2%). Clavien Grade 3 or higher complications occurred in 14 patients (5.7%). The 30- and 90-day mortality was 0.8% (n = 2). Of patients with abdominal symptoms, 63.2% reported improvement of symptoms post-operatively. Conclusion: A hemangioma resection can be safely performed at high-volume institutions. The primary indication for surgery remains for intractable symptoms. The development of severe complications associated with non-operative management remains a rare event, ultimately challenging the necessity of additional surgical indications for a hemangioma resection.

Original languageEnglish (US)
Pages (from-to)924-928
Number of pages5
JournalHPB
Volume16
Issue number10
DOIs
StatePublished - 2014

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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