1.Treatment of liver cavernous hemangioma with stripping operation
Hongliang LIU ; Guangzhen CAI ; Xiaolong WU ; Yajie ZHAO ; Shuai XIANG ; Yifa CHEN ; Xiaoping CHEN
Chinese Journal of Hepatic Surgery(Electronic Edition) 2014;(4):223-225
Objective To evaluate the safety and application value of stripping operation for the treatment of liver cavernous hemangioma. Methods Clinical data of 56 patients with liver cavernous hemangioma who underwent stripping operation in Hepatic Surgery Center, Tongji Hospital, Tongji Medical college, Huazhong University of Science and Technology from May 2008 to May 2012 were analyzed retrospectively. There were 21 males and 35 females with age ranging from 23 to 65 years old and the median age of 44 years old. The informed consents of all patients were obtained and the ethical committee approval was received. The patients received combined intravenous and endotracheal anesthesia. Occluding stripes were preset at the first porta and infrahepatic inferior vena cava, and the proper hepatic artery was dissected and clamped. Liver cavernous hemangioma was sharply dissected along its surface when the tumor got soft and shrunken. And the vessels in and out of the tumor were ligated. Pringle maneuver and infrahepatic inferior vena cava interruption (interruption length: 5-15 min) were performed in case of uncontrolled bleeding during the stripping operation. Results All the liver cavernous hemangiomas were enucleated successfully. The mean intraoperative blood loss of the patients was (437±135)ml, and no case received blood transfusion. Rupture of right hepatic vein was observed in 4 cases and rupture of middle hepatic vein in 2 cases during the operations, and they were successfully repaired with Prolene sutures. No death was observed during the perioperative period. Right-sided pleural effusion and peritoneal effusion were observed in 7 cases and bile leakage at the cut surface of liver in 1 case after the operations, and all were cured by drainage and symptomatic treatment. Conclusion Stripping operation is a safe and effective surgical procedure for liver cavernous hemangioma.