[The treatment of benign lesions of the liver. Indications and surgical approach]. / Il trattamento delle formazioni benigne del fegato. Indicazioni e strategia chirurgica.

ABSTRACT

Benign formations in the liver constitute a heterogeneous group of pathology lesions that are rarely found clinically. In the period between January 1985 and June 1992, 81 patients, affected by benign formations of the liver, were observed at the Institute of the III Surgical Clinic of Rome "La Sapienza". Most of these lesions are asymptomatic and their diagnosis is mostly casual. Among these we found 48 cases of echinococcus cystis, 13 cases of congenital cystic formations, 2 amoebiasis cases, and 1 case the ecografic exam, which shows an hepatic formation to the fifth segment, was not in conformity with the cytologic exam which proved negative because of cellular abnormalities of any nature, therefore it's constituted by normal parenchyma. Consequently the patient was discharged. We operated on 65 patients. The complications found in the patient operated on were not important and we had the death of only 1 patient affected by hepatic abscess on the 3rd day after surgery because of septicemia and cardio-circulatory problems. The follow-up made after a certain time has resulted negative because of relapses if we exclude 1 case of echinococcus cystis wherein we found a serological relapsing. In our experience and according to most of the authors, the operation must take place always in cases such as adenoma, cystoadenoma, hemangiomas having a diameter higher than 3 cm, echinococcus cysts, syntomatic formations and when we have complications. For all other cases we must limit ourselves to observation over a certain period both the dimensions and morphological modification of the lesions.