[Giant hemangioma of the liver (author's transl)]

This case is reported because of the technical problems raised when excision of very large tumors of the liver is required. A patient was found to have a hemangioma of the right lobe of the liver. A right hepatectomy to include Spiegel's lobe was performed by a subcostal approach extended to a right thoracophrenotomy. After clamping the vascular pedicle of the right liver, the section of the liver was removed and a tumor weighing 3.420 g discovered. Postoperative recovery was uneventful. During right hepatectomies for very large tumors, excellent control of the inferior vena cava and right superior hepatic vein can be maintained by the use of thoracophrenotomy associated with laparotomy. Though the possibility of complexe vascular exclusion of the liver has to be considered during hepatic sectioning, this aves not appear to be essential, and the use of manual dissection after clamping the vascular pedicles of the right liver is a rapid and certain procedure.