TY - JOUR
T1 - An algorithm for the accurate identification of benign liver lesions
AU - Kim, Joseph
AU - Ahmad, Syed A.
AU - Lowy, Andrew M.
AU - Buell, Joseph F.
AU - Pennington, Linda J.
AU - Moulton, Jonathan S.
AU - Matthews, Jeffrey B.
AU - Hanto, Douglas W.
PY - 2004/2
Y1 - 2004/2
N2 - Background: Benign liver lesions may be difficult to characterize preoperatively. In most instances, determination of the etiology of a hepatic mass makes its management decisions clear-cut. We present our experience using an algorithm for the management of liver masses of suspected benign or uncertain pathology and highlight this approach along with our surgical experience in benign liver lesions. Methods: Seventy-one patients underwent hepatectomy with a preoperative diagnosis of benign disease or unknown etiology from December 1992 to February 2002. Patients were preoperatively assessed with computed tomography, along with other imaging studies, as indicated. Final pathology was reviewed to confirm the preoperative diagnosis. Results: Ninety-two percent (65 of 71) were correctly characterized preoperatively. Diagnosis was inaccurate in 6 patients. Of these patients, final pathology revealed focal nodular hyperplasia in 4 patients. The remaining 2 patients, who had adenoma, were found to harbor malignancy within the surgical specimens. Conclusions: An algorithm to manage liver lesions resulted in a high diagnostic accuracy of a preoperative evaluation. Hepatic resection for benign disease can be performed with low morbidity and mortality and is highly successful in achieving relief for symptomatic patients.
AB - Background: Benign liver lesions may be difficult to characterize preoperatively. In most instances, determination of the etiology of a hepatic mass makes its management decisions clear-cut. We present our experience using an algorithm for the management of liver masses of suspected benign or uncertain pathology and highlight this approach along with our surgical experience in benign liver lesions. Methods: Seventy-one patients underwent hepatectomy with a preoperative diagnosis of benign disease or unknown etiology from December 1992 to February 2002. Patients were preoperatively assessed with computed tomography, along with other imaging studies, as indicated. Final pathology was reviewed to confirm the preoperative diagnosis. Results: Ninety-two percent (65 of 71) were correctly characterized preoperatively. Diagnosis was inaccurate in 6 patients. Of these patients, final pathology revealed focal nodular hyperplasia in 4 patients. The remaining 2 patients, who had adenoma, were found to harbor malignancy within the surgical specimens. Conclusions: An algorithm to manage liver lesions resulted in a high diagnostic accuracy of a preoperative evaluation. Hepatic resection for benign disease can be performed with low morbidity and mortality and is highly successful in achieving relief for symptomatic patients.
KW - Benign liver disease
KW - Cavernous hemangioma
KW - Focal nodular hyperplasia
KW - Hepatic adenoma
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U2 - 10.1016/j.amjsurg.2003.11.018
DO - 10.1016/j.amjsurg.2003.11.018
M3 - Article
C2 - 14769319
AN - SCOPUS:0842330916
SN - 0002-9610
VL - 187
SP - 274
EP - 279
JO - American Journal of Surgery
JF - American Journal of Surgery
IS - 2
ER -