Diagnosis and Minimally Invasive Treatment Modes of Hepatic Hemangiomas

V.V. Khatsko, A.D. Shatalov, V.N. Voityuk, V.A. Matviyenko, Glazkov A.I. Glazkov A.I.

Abstract


Objective of the work — to examine the effectiveness of different methods for diagnosis of hepatic hemangiomas, to improve treatment outcomes by optimizing minimally invasive interventions.
Material and Methods. The results of diagnosis and minimally invasive treatment of 52 patients with hepatic hemangiomas for the last 10 years were analyzed. Among them there were 38 women and 14 men aged 22–68 years. Tumor diameter ranged from 3 to 16 cm. For the diagnosis of this disease we used following methods (in various combinations): clinical and laboratory, ultrasound, contrast-enhanced computed and magnetic resonance imaging, angiography, laparoscopy, hepatic biopsy. Laparoscopic procedures were conducted using instruments manufactured by Wolf and Karl Storz (Germany). Diagnostic punctures had been carried out using 12–22 G needles. Findings were processed using personal computer in Statistica for Windows software environment. In the clinic we have carried out 52 videoendoscopic operations.
Results and Discussion. Types of 52 videoendoscopic operations: liver resection — 39 (75 %) and enucleation — 13 (25 %). In 12 patients we used «Method of elimination of residual cavities of the liver» developed by us. Postoperative bleeding or bile leakage weren’t detected. Hospital stay was 5–8 days.
Conclusions. Modern methods of investigation are essential to clarify the localization of hemangioma and planning the extent of laparoscopic surgery. Methods of choice are enucleation of tumor or resection within III–VII liver segments. Application of ultrasonic scalpel and method of operation developed by us can reduce the duration and cost of operations.


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DOI: https://doi.org/10.22141/1997-2938.2.25.2014.83072

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