Enucleation of liver hemangiomas: is there a difference in surgical outcomes for centrally or peripherally located lesions?

BACKGROUND: Partial hepatectomy for centrally located liver lesions is technically more challenging than that for peripheral lesions. Enucleation of liver hemangiomas is easier and safer than partial hepatectomy. Whether enucleation gives the same surgical outcomes for both centrally and peripherally located hemangiomas is unknown. This study aimed to evaluate the difference in surgical outcomes of enucleation of centrally and peripherally located liver hemangiomas.

METHODS: This study used a prospectively maintained database consisting of a consecutive series of patients who underwent enucleation of liver hemangiomas in a tertiary referral center from January 2004 to December 2006. Surgical variables, length of hospital stay, and postsurgical complications were compared between centrally and peripherally located liver hemangiomas.

RESULTS: During the study period, 172 patients underwent enucleation of hepatic hemangiomas. The lesions were centrally located in 76 patients (44.2%) and peripherally located in 96 patients (55.8%). The 2 groups were comparable in demographic data and lesion characteristics. There was no hospital mortality. The major complication rates were low in both groups (2.6% vs. 3.1%; P = .848). Enucleation of centrally located liver hemangiomas required significantly longer vascular inflow occlusion time (P <.001), longer operating time (P <.001), and more blood transfusion (P = .001). This group also had a higher volume of blood loss (P = .004) and longer hospital stay (P = .024) than the group with peripherally located liver hemangiomas.

CONCLUSIONS: Enucleation is a safe surgery for hemangiomas in any part of the liver, although it is technically more demanding for centrally than peripherally located hemangiomas.