Incidence of benign pathology in patients undergoing hepatic resection for suspected malignancy

Surgeon. 2003 Feb;1(1):32-8. doi: 10.1016/s1479-666x(03)80006-9.


Background: Confirming the presence of hepatic or proximal bile duct malignancy pre-operatively remains difficult and some patients may undergo surgical resection for suspected malignant lesions which subsequently turn out to be benign. The aim of this study was to establish whether improvements in pre-operative staging might better identify this patient population.

Methods: Analysis of a prospectively collected database, which has been maintained in our unit since 1988.

Results: Of 250 consecutive patients undergoing hepatic resection for presumed malignancy, 18 (7.2%) were shown to have benign pathology. These "false positive" rates were 4 out of 160 (2.5%) resections for colorectal metastases, 4 out of 49 (8.2%) resections for other solid hepatobiliary tumours and 10 out of 41 (24.4%) resections for hilar cholangiocarcinoma. Four of the 18 patients (22%) developed post-operative complications but there was no postoperative mortality.

Conclusion: Although hepatic resection remains a potentially curative procedure for patients with tumours involving the liver parenchyma or proximal bile ducts, pre-operative confirmation of malignancy remains difficult. Despite appropriate investigation a subset of patients with benign disease will still be subjected to major hepatic resection which should be undertaken in a specialist unit.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Age Distribution
  • Aged
  • Bile Duct Neoplasms / epidemiology
  • Bile Duct Neoplasms / pathology*
  • Bile Duct Neoplasms / surgery*
  • Biopsy, Needle
  • Cholangiopancreatography, Endoscopic Retrograde / methods
  • Cohort Studies
  • Diagnosis, Differential
  • Female
  • Hepatectomy / methods
  • Humans
  • Immunohistochemistry
  • Incidence
  • Ireland / epidemiology
  • Liver / pathology
  • Liver Cirrhosis / epidemiology
  • Liver Cirrhosis / pathology*
  • Liver Cirrhosis / surgery*
  • Liver Neoplasms / epidemiology
  • Liver Neoplasms / pathology*
  • Liver Neoplasms / surgery*
  • Male
  • Middle Aged
  • Preoperative Care / methods
  • Prospective Studies
  • Risk Assessment
  • Sex Distribution
  • Tomography, X-Ray Computed