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. 2015 May-Jun;21(3):222-8.
doi: 10.5152/dir.2014.14270.

Preoperative arterial embolization of large liver hemangiomas

Serdar Topaloğlu  1 , Şükrü Oğuz, Orhan Kalaycı, M Halil Öztürk, Adnan Çalık, Hasan Dinç, Ümit Çobanoğlu
Affiliations

Preoperative arterial embolization of large liver hemangiomas

Serdar Topaloğlu et al. Diagn Interv Radiol. 2015 May-Jun.

Abstract

Purpose: We aimed to investigate the efficacy and safety of preoperative selective intra-arterial embolization (PSIAE) in the surgical treatment of large liver hemangiomas.

Methods: Data of 22 patients who underwent resection of large liver hemangiomas were retrospectively analyzed. PSIAE was performed in cases having a high risk of severe blood loss during surgery (n=11), while it was not applied in cases with a low risk of blood loss (n=11).

Results: A total of 19 enucleations and six anatomic resections were performed. Operative time, intraoperative bleeding amount, Pringle period, and blood transfusion were comparable between the two groups (P > 0.05, for all). The perioperative serum aspartate transaminase level was not different between groups (P = 1.000). Perioperative total bilirubin levels were significantly increased in the PSIAE group (P = 0.041). Postoperative hospital stay was longer in the PSIAE group. Surgical complications were comparable between groups (P = 0.476).

Conclusion: Patients who underwent PSIAE due to a high risk of severe blood loss during resection of large liver hemangiomas had comparable operative success as patients with a low risk of blood loss who were operated without PSIAE. Hence, PSIAE can be used for the control of intraoperative blood loss, especially in surgically difficult cases.

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Figures

Figure 1.
Figure 1.
CT image shows a cavernous hemangioma in segments IVB, V, and VI. The largest diameter of the lesion was 13 cm.
Figure 2. a, b.
Figure 2. a, b.
Selective angiography of the celiac trunk before intra-arterial embolization (a) demonstrates the feeders of the hemangioma. Panel (b) shows successful occlusion of the feeders.
Figure 3. a, b.
Figure 3. a, b.
Preoperative selective intra-arterial embolization of hemangioma was associated with slight necrosis at day 3 postembolization (a). Panel (b) shows the dissection plan during enucleation.
See this image and copyright information in PMC

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