22/06/2022
Female pt, 48 ys
Diabetic , hypertensive
History of thyroidectomy 2 times
presented with Rt hypochondrial pain since 2 month.
Preop. Evaluation done by
*Triphasic CT abdomen with oral and IV contrast revealed
Huge haemangioma 15*12 cm at segments V,VI with characteristic peripheral nodular enhancment
• lap. Investigation for exclusion of other cystic pathological lesion were -ve ( alfa Feto ptn, hydatid serology, CEA,CA19.9 )
Operative intervention revealed
• Huge hemangioma at seg. 5 , 6 with high vasularity
• liver mobilization ,prelimenary pringle manuver was done , dissection of GB from bed to expose Rt portal track which was adherent to the cyst wall , inflow and outflow vascular control was obtained to minimize blood loss
• the dissicion was Bisegmentectomy leaving a sufficient future liver remnant since the liver was steatotic
• parenchymal transection was done using combination of CUSA & Enseal device .....
استئصال تشريحي لوحمه كبديه كبيره الحجم بالفص الايمن من الكبد
