ABSTRACT
Patient with giant rapidly growing liver hemangioma who carried out right hemihepatectomy is reported. The feature if this case is choledocholithiasis after liver resection followed by its rare complication (spontaneous biloma) in 6 years after surgery. Minimally invasive procedures (percutaneous drainage, endoscopic papillotomy and stenting) eliminated each of bile collection and cause of biliary obstruction without surgical intervention.
Subject(s)
Cholangiopancreatography, Endoscopic Retrograde/methods , Cholestasis, Extrahepatic , Hepatectomy/adverse effects , Liver Neoplasms , Lower Body Negative Pressure/methods , Postoperative Complications , Abdominal Cavity/pathology , Adult , Choledocholithiasis/diagnostic imaging , Choledocholithiasis/etiology , Choledocholithiasis/therapy , Cholestasis, Extrahepatic/diagnostic imaging , Cholestasis, Extrahepatic/etiology , Cholestasis, Extrahepatic/therapy , Drainage/methods , Female , Hemangioma/pathology , Hemangioma/surgery , Hepatectomy/methods , Humans , Lithotripsy/methods , Liver Neoplasms/pathology , Liver Neoplasms/surgery , Magnetic Resonance Imaging , Organ Size , Treatment Outcome , UltrasonographyABSTRACT
Liver resections by metastatic colorectal cancer are considered to be seldom applicable on the reason of bilobar lesions and insufficient volume of the left liver lobe. The two-stage operations have been suggested for such situations. Of 276 patients, treated in our centre, 52 cases, unsuitable for the single-stage liver resection according to the preoperative data, had been retrospectively chosen. All these patients had the procedure of the right branch of vena porta occlusion, which aimed the compensatory hypertrophy of the left liver lobe. The efficacy of the occlusion was up to 73%. The median left lobe enlargement was 11%. The increase of the summary diameter of metastases was 60,4% (from 53 mm to 85 mm; p < 0,0001). The follow-up time was from 3 to 96 months. The three-year survival time was significantly higher in patients with the completed two-stage surgical treatment in comparison with those, who were refused the liver resection--77 and 43%, respectively. The multifactorial analysis revealed the only independent factor of the survival time--the extrahepatic intraabdominal lesion (p = 0,014).
Subject(s)
Colorectal Neoplasms/pathology , Embolization, Therapeutic/methods , Ligation/methods , Liver Neoplasms , Liver/blood supply , Aged , Disease Progression , Female , Follow-Up Studies , Hepatectomy/methods , Humans , Liver/pathology , Liver/surgery , Liver Neoplasms/secondary , Liver Neoplasms/surgery , Male , Middle Aged , Portal Vein/surgery , Survival Rate , Treatment OutcomeABSTRACT
AIM: To define significance of radiological diagnostics in detection and characterization of hepatic hemangiomas. MATERIALS AND METHODS: Analysis of 176 patients with liver hemangiomas was performed. All patients were investigated or consulted in hepato-pancreato-biliary surgical department. US, CT, MRI, angiography, scintigraphy and liver biopsy were compared. RESULTS: Contemporary noninvasive diagnostics disclose liver hemangiomas with high confidence without need for tumor biopsy. MRI and CT with intravenous enhancement are the most efficient modalities for detection of hepatic hemangiomas.
