Laparoscopic liver resection for hemorrhagic hepatocellular adenoma in a pregnant patient

Gryspeerdt, F.; Aerts, Raymond

doi:10.1080/00015458.2017.1379790

Cited by 6 publications

(5 citation statements)

References 18 publications

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“…Elective, uncomplicated, hepatic resections were performed up to the second trimester. 27,28,37,38,42,51 No minimally invasive strategy was identified as superior due to limited observations. Three patients were treated by US-guided RFA: two during pregnancy (patients 2 & 75) and one prior to the second pregnancy (patient 9-2).…”

Section: Discussionmentioning

confidence: 99%

“…Only one bleeding I-HCA was observed (case 79). 42 Four out of five HCA induced postpartum bleedings occurred during the first two weeks after delivery.…”

Section: Hca Induced Bleeding During Pregnancy and Puerperiummentioning

confidence: 97%

“…11, OCP status was reported in most studies (79%). 26,28,30,[42][43][44][45]52 Four cohort studies reported insufficient information on patient characteristics, HCA size, and HCA behavior for reporting and pooling of individual patients. 3,[54][55][56] One case report and one cohort study reported on hepatocyte nuclear factor 1a maturity onset diabetes of the young (HNF1A-MODY)-associated HCA.…”

Section: Data Extraction and Critical Appraisalmentioning

confidence: 99%

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Behavior and complications of hepatocellular adenoma during pregnancy and puerperium: a retrospective study and systematic review

Haring

Spijkerboer

Cuperus

et al. 2021

HPB

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Background: Hepatocellular adenomas (HCA) are benign liver tumors at risk of hemorrhage. The influence of pregnancy on HCA growth and potential bleeding remains unclear. This study investigates HCA-associated behavior and bleeding complications during or shortly after pregnancy. Methods: (I) Single center retrospective cohort study of HCA during and after pregnancy (II) Systematic literature review.Results: The retrospective study included 11 patients, of which 4 with HCA 5 cm. In only two patients HCA showed growth during pregnancy. In this local cohort, no HCA-related hemorrhages occurred during median follow-up of 34 months (interquartile range 19-58 months). The systematic review yielded 33 studies, totaling 90 patients with 99 pregnancies. Of 73 pregnancies without prior HCA-related intervention, 39 HCA remained stable (53.4%), 11 regressed (15.1%), and 23 (31.5%) progressed.Fifteen HCA-related hemorrhages occurred in HCA measuring 6.5-17.0 cm. Eight patients experienced bleeding during pregnancy, two during labor and five postpartum.Discussion: Although hemorrhage of HCA during or shortly after pregnancy is rare and only reported in HCA 6.5 cm, it can be fatal. Pregnancy in women with HCA, regardless of size, warrant a close surveillance strategy. Observational studies on behavior and management of HCA 5 cm during and immediately after pregnancy are needed.

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Section: Discussionmentioning

confidence: 99%

“…Only one bleeding I-HCA was observed (case 79). 42 Four out of five HCA induced postpartum bleedings occurred during the first two weeks after delivery.…”

Section: Hca Induced Bleeding During Pregnancy and Puerperiummentioning

confidence: 97%

Section: Data Extraction and Critical Appraisalmentioning

confidence: 99%

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Behavior and complications of hepatocellular adenoma during pregnancy and puerperium: a retrospective study and systematic review

Haring

Spijkerboer

Cuperus

et al. 2021

HPB

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“…Pregnancy induces not only an increased level of endogenous hormones but also an increased liver vascularity that puts the patient at risk for adenoma rupture especially in the third trimester [81]. However, a ruptured HA discovered during pregnancy should be immediately resected by laparotomy or laparoscopy [28,82,83].…”

Section: Management Of Pregnant Patientmentioning

confidence: 99%

Challenging Issues in Hepatic Adenoma

Boeți¹,

Tivadar²,

Lupescu³

et al. 2019

Liver Disease and Surgery [Working Title]

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Hepatic adenoma is known as a benign lesion encountered mainly in female patients and classically linked to the administration of oral contraceptives. In the last decade, the risk factors for its occurrence have changed and so did the sex ratio. The histopathological classification of hepatic adenomas was found to be related with certain genetic mutations that determine the risk for malignancy. The diagnosis of hepatic tumor is correlated with clinical and imaging data in an effort not only to rule out other tumors but also to distinguish the subtype of adenoma, which is very important for the management of the patient. The ultimate diagnosis is established by pathologists by routine histopathological and specific immunohistochemical staining. There are two major issues that pathologists need to recognize: the presence of β-catenin gene mutation and/or malignant degeneration. The best imaging examination is considered to be MRI. However, along with MRI, ultrasound and computer tomography have proved themselves to be effective not only in evaluating the number, size, localization, and complications of hepatic adenomas, but also in identifying their subtype. A detailed presentation of characteristics of all groups of hepatic adenoma is provided. The means of management of hepatic adenomas are documented and decisional algorithm is explained, based on certain criteria.

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“…Anatomically favorable located lesions can be safely managed with laparoscopic liver resection. Laparoscopic liver resection should be considered as part of the currently available strategies for hepatocellular adenoma during pregnancy [39].…”

Section: Variables Llr(n=102) Olr(n=198) P Valuementioning

confidence: 99%

Cost and Clinical Efficacy of Laparoscopic vs. Open Approach in Liver Resection

Sharma¹,

Liang²,

Xiao³

et al. 2018

Surgery Curr Res

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Background: Hesitation but gradual recognition of laparoscopic liver resection has been gaining popularity in developed countries among the specialized hospitals. On contrary, there has always been a debate about high cost and complexity of laparoscopic as compared to open liver resection resulting in the delayed adoption of laparoscopic approach in many centers. Methods: We retrospectively reviewed medical records of all patients at the 6 th department (Hepatobiliary Unit) of the 1 st affiliated hospital of Harbin Medical University who underwent elective LLR (n=102) or OLR (n=198) from January 1 st , 2014 to November 1 st , 2017. Patient demographics, diagnosis, operation type, operative duration, estimated blood loss, blood transfusion requirement pathology, length of hospital stay, ICU stays and complications were compared between laparoscopic and open approach. Hospital billing data were collected for each case to determine the mean hospital costs per case. Conclusion: Our study justifies that LLR is safe with remarkably better clinical benefits as well cost advantage to some extent. Short operating duration, short hospital stay, lower chances for ICU need, less blood loss, less blood transfusion requirement, and low occurrence of complications are benefits offered by the laparoscopic procedure.

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Laparoscopic liver resection for hemorrhagic hepatocellular adenoma in a pregnant patient

Cited by 6 publications

References 18 publications

Behavior and complications of hepatocellular adenoma during pregnancy and puerperium: a retrospective study and systematic review

Behavior and complications of hepatocellular adenoma during pregnancy and puerperium: a retrospective study and systematic review

Challenging Issues in Hepatic Adenoma

Cost and Clinical Efficacy of Laparoscopic vs. Open Approach in Liver Resection

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