Treatment of ruptured hepatocellular adenoma
- 1 February 2001
- journal article
- research article
- Published by Oxford University Press (OUP) in British Journal of Surgery
- Vol. 88 (2), 207-209
- https://doi.org/10.1046/j.1365-2168.2001.01648.x
Abstract
Background As the morbidity and mortality rates associated with emergency resection in patients with a ruptured hepatocellular adenoma are high, the authors have favoured initial non-operative management in haemodynamically stable patients. Methods A retrospective study was performed to evaluate the treatment of ruptured hepatocellular adenoma. Results Over a 21-year interval, 12 patients presented with a ruptured hepatocellular adenoma. Haemodynamic observation and support was the initial management in all 12 patients. Three underwent urgent laparotomy and gauze packing because of haemodynamic instability; no emergency liver resection was necessary. Eight patients had definitive surgery; three developed postoperative complications but none died. Regression of the tumour was observed in three of four patients treated conservatively. Conclusion The initial management of a ruptured hepatocellular adenoma should be haemodynamic stabilization. Definitive resection is required for rebleeding or for tumours exceeding 5 cm in diameter. A conservative approach may well be justified in case of regression of an asymptomatic adenoma.Keywords
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