Outcome after a liver resection of benign lesions.

BACKGROUND Benign liver tumours represent a challenge in clinical management. There is considerable controversy with respect to the indications for surgery as the evidence for surgical treatment is variable. The aim of this retrospective study was to analyse the indication and outcome after resection of benign, solid liver lesions. METHODS Data of 79 patients, who underwent liver resection between 2001 and 2012, were analysed for demographic and outcome parameters. RESULTS Thirty-eight patients with focal nodular hyperplasia (48%), 23 patients with haemangioma (29%) and 18 patients with hepatocellular adenoma (23%) underwent a hepatic resection. A major hepatic resection was performed in 23 patients (29%) and a minor resection in 56 patients (71%). The post-operative mortality rate was zero and the 30-day morbidity rate 13.9%. After a median follow-up of 64 months, 75 patients (95%) were alive, and no patient had developed recurrent disease. Fifty-four patients (68%) were pre-operatively symptomatic, of which, 87% had complete or partial relief of symptoms after a liver resection. The incidence of symptoms increased with the lesions' size. DISCUSSION The management of benign liver lesions necessitates an individualized therapy within a multidisciplinary, evidence-based, treatment algorithm. Resection of benign liver lesions can be performed safely in well-selected patients without mortality and low post-operative morbidity.

[1]  M. Büchler,et al.  Impact of portal vein resection on oncologic long-term outcome in patients with hilar cholangiocarcinoma. , 2015, Surgery.

[2]  C. Sempoux,et al.  Hepatocellular adenoma management: call for shared guidelines and multidisciplinary approach. , 2015, Clinics and research in hepatology and gastroenterology.

[3]  A. Ejaz,et al.  Benign Solid Tumors of the Liver: Management in the Modern Era , 2015, Journal of Gastrointestinal Surgery.

[4]  François Cauchy,et al.  Diagnosis and management of solid benign liver lesions , 2014, Nature Reviews Gastroenterology &Hepatology.

[5]  M. Büchler,et al.  Factors predictive of survival after stapler hepatectomy of hepatocellular carcinoma: a multivariate, single-center analysis. , 2014, Anticancer research.

[6]  O. Farges,et al.  Laparoscopic left lateral resection is the gold standard for benign liver lesions: a case-control study. , 2014, HPB : the official journal of the International Hepato Pancreato Biliary Association.

[7]  Robert C. G. Martin,et al.  Health-related quality of life changes following major and minor hepatic resection: the impact of complications and postoperative anemia. , 2013, American journal of surgery.

[8]  J. Zucman‐Rossi,et al.  Benign hepatocellular nodules: what have we learned using the patho-molecular classification. , 2013, Clinics and research in hepatology and gastroenterology.

[9]  J. Koea Hepatic incidentaloma: the rule of tens. , 2013, HPB : the official journal of the International Hepato Pancreato Biliary Association.

[10]  Laura H. Tang,et al.  Management of hepatocellular adenoma: comparison of resection, embolization and observation. , 2013, HPB : the official journal of the International Hepato Pancreato Biliary Association.

[11]  M. Gagner,et al.  Has laparoscopy increased surgical indications for benign tumors of the liver? , 2013, Langenbeck's Archives of Surgery.

[12]  P. Herzog,et al.  “Incidentaloma” of the Liver: Management of a Diagnostic and Therapeutic Dilemma , 2012, HPB surgery : a world journal of hepatic, pancreatic and biliary surgery.

[13]  Jürgen Weitz,et al.  Post-hepatectomy haemorrhage: a definition and grading by the International Study Group of Liver Surgery (ISGLS). , 2011, HPB : the official journal of the International Hepato Pancreato Biliary Association.

[14]  D. Seehofer,et al.  Safety of liver resection and effect on quality of life in patients with benign hepatic disease: Single center experience , 2011, BMC surgery.

[15]  M. Koch,et al.  Bile leakage after hepatobiliary and pancreatic surgery: a definition and grading of severity by the International Study Group of Liver Surgery. , 2011, Surgery.

[16]  Jürgen Weitz,et al.  Posthepatectomy liver failure: a definition and grading by the International Study Group of Liver Surgery (ISGLS). , 2011, Surgery.

[17]  P. Schemmer,et al.  Benigne solide Tumoren der Leber , 2011 .

[18]  M. R. Schön Stellenwert laparoskopischer Leberresektionen , 2010, Der Chirurg.

[19]  P. Schirmacher,et al.  Liver Resection for Multimodal Treatment of Breast Cancer Metastases: Identification of Prognostic Factors , 2010, Annals of Surgical Oncology.

[20]  Deha Erdogan,et al.  Morbidity and mortality after liver resection for benign and malignant hepatobiliary lesions , 2009, Liver international : official journal of the International Association for the Study of the Liver.

[21]  M. Büchler,et al.  Liver transection using vascular stapler: a review. , 2008, HPB : the official journal of the International Hepato Pancreato Biliary Association.

[22]  Jay P. Heiken,et al.  Distinguishing benign from malignant liver tumours , 2007, Cancer imaging : the official publication of the International Cancer Imaging Society.

[23]  H. Friess,et al.  The Use of Endo-GIA Vascular Staplers in Liver Surgery and Their Potential Benefit:A Review , 2007, Digestive Surgery.

[24]  Hans-Peter Meinzer,et al.  The impact of virtual operation planning on liver surgery , 2007 .

[25]  S. Paggi,et al.  Elective surgery for benign liver tumours. , 2007, The Cochrane database of systematic reviews.

[26]  Ran-Chou Chen,et al.  Transcatheter arterial chemoembolization in patients with hepatocellular carcinoma and coexisting hepatic cavernous hemangioma , 2006, European Radiology.

[27]  H. Friess,et al.  Stapler Hepatectomy is a Safe Dissection Technique: Analysis of 300 Patients , 2006, World Journal of Surgery.

[28]  N. Demartines,et al.  Classification of Surgical Complications: A New Proposal With Evaluation in a Cohort of 6336 Patients and Results of a Survey , 2004, Annals of Surgery.

[29]  J. McCall,et al.  Hepatic adenomas in male patients. , 2004, HPB : the official journal of the International Hepato Pancreato Biliary Association.

[30]  A. Lowy,et al.  An algorithm for the accurate identification of benign liver lesions. , 2004, American journal of surgery.

[31]  V. Vilgrain,et al.  Resection of presumed benign liver tumours , 1993, The British journal of surgery.

[32]  R. Hermann,et al.  Hepatic resection in 128 patients: a 24-year experience. , 1987, Surgery.

[33]  M. Schön [Value of laparoscopic liver resection]. , 2010, Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen.