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Background: Surgical treatment of giant hepatic hemangioma larger than 10 cm in diameter often requires major laparoscopic liver resection (LLR), which is very difficult and has a high risk of bleeding. There is no consensus as to whether giant hepatic hemangioma is an indication or a contraindication for laparoscopic surgery., Methods: From 2011/09 to 2018/05, 58 patients with giant hepatic hemangioma larger than 10 cm underwent laparoscopic surgery. They were divided into high-difficulty (HD) group and low-difficulty (LD) group according to the operation difficulty score. The perioperative data of the two groups were analyzed and compared., Results: There were 30 patients in the LD group and 28 in the HD group. No differences were showed in sex, age, ASA grade, tumor size, operation time, conversion rate, intraoperative and post-operative blood transfusion rate, and post-operative complications between the two groups. The amount of bleeding in the HD group was significantly higher than that in the LD group (285.7 ± 224.0 vs 189.6 ± 157.6 ml, p = 0.007). The time of hepatic hilar occlusion in the HD group was longer than that in the LD group (25.4 ± 8.8 vs 20.6 ± 7.3 min, p = 0.001), and the rate of hepatic hilar occlusion in the HD group was also higher than that in the LD group (71.4% vs 33.3%, p = 0.004). The incidence of hospitalization days and discharge time in the LD group were shorter than those in the HD group (6.3 ± 1.6 vs 8.2 ± 1.4 days, p = 0.000; 16.4 ± 5.5 vs 21.9 ± 4.6 h, p = 0.019). There was no significant difference in enzymatic parameters between the two groups after operation., Conclusions: Although there are great difficulties and risks objectively, laparoscopic treatment of giant hepatic hemangioma is safe and feasible.

Objective：To compare the clinical outcome and literature review of laparoscopic microwave ablation and laparoscopic hepatectomy for the treatment of giant hepatic hemangioma,and explore the treatment strategiesgiant hepatic hemangioma. Method： From January 2020 to December 2022,a total of 18 patientsdiagnosed with giant hepatic hemangiomaunderwent laparoscopic vascular tumor microwave ablation at the First Affiliated Hospital of Nanjing Medical University. Based on the size,location,and body mass index of the hemangioma,18 patients who underwent laparoscopic hemangioma resection duringthe same period were selected for a 1∶ 1 matched case⁃control study. The surgical duration,intraoperative blood loss,postoperative complications,postoperative hospital stay, andpostoperative liver function［alanine transaminase(ALT),aspartate transaminase(AST),and total bilirubin(TBIL) ］on the first day were compared between two groups of patients,as well as the short ⁃term and long ⁃term complicationsand prognosis. Results：The surgical duration in the laparoscopic microwave ablation group was shorter than that in the laparoscopic surgery group(P < 0.001),the intraoperative blood loss was lower than that in the laparoscopic surgery group(P < 0.001),and the postoperative hospital stay was shorter than that in the laparoscopic surgery group(P < 0.001) . There were no significant difference in the incidence of postoperative adverse reaction(P > 0.05),postoperative liver function on the first day after surgery(ALT,AST,TBIL,P > 0.05) between the two groups. No midium ⁃ term or long ⁃ term complications were observedduring the follow ⁃ up period after surgery in both groups. Conclusion：Laparoscopic microwave ablation is an effective and safe treatment for giant liverhemangioma,and it can significantly reduce intraoperative blood loss,surgical duration,and postoperative hospital stay. [ABSTRACT FROM AUTHOR]

Background: To report the safety and effectiveness of laparoscopic intratumoral resection facilitated by coagulation (LIRC) compared with laparoscopic hepatectomy (LH) in treating giant hepatic hemangioma.Methods: From 2017 to 2020, 19 consecutive patients with giant hepatic hemangioma (≥ 10 cm) received LIRC in one center. We selected a subgroup of 103 patients treated by LH in other four centers who well matched the 19 consecutive patients treated with LIRC, in a 1:1 fashion based on the tumor location, tumor size, and body mass index. Furthermore, the differences in technical success, operative time, operative blood loss, change of laboratory indexes, hospital stays, complication and clinical responds are compared between the two groups.Results: Technical success was achieved in all 38 patients. Patients in the LIRC group had a relative shorter operative time (P < 0.001) and less operative blood loss (P = 0.003). The serum levels of C-reactive protein (CRP), total bilirubin (TBil), alanine aminotransferase (ALT), and aspartate transaminase (AST) were elevated significantly (P < 0.05) 1 day after the resection and returned to normal within 7 days in both groups; however, relatively lower serum levels of those indexes were observed in the LIRC group (P < 0.05). The total complication rate was relatively lower in the LIRC group compared with the LH group (P = 0.029). Patients in the LIRC group had shorter hospital stays than those in the LH group (P = 0.010). The clinical response was similar in the two groups.Conclusions: LIRC is safe and effective for treating giant hepatic hemangioma. [ABSTRACT FROM AUTHOR]

Abstract: Hemangiomas are the most common benign tumors of the liver. Most of them remain stable. However, when a hemangioma continues to grow, it may become symptomatic. We describe a 40-year-old woman who initially presented with a hemangioma approximately 3 cm in diameter in the right lobe of the liver. Eight years after the initial presentation, the hemangioma had grown to 11 × 8 cm with the symptom of abdominal pain. She was managed with conservative treatment at another hospital. However, the symptoms and tumor bothered her physically and psychologically for 1 year. Surgical resection was performed to relieve her symptoms. The huge tumor was compressing the inferior vena cava and was very close to the middle hepatic vein, which made the operation difficult. The postoperative course was uneventful. We suggest early surgical resection for symptomatic giant hepatic hemangiomas. We also review reports in the literature about the treatment of symptomatic hepatic hemangiomas, including surgery, transcatheter arterial embolization and radiofrequency ablation. [Tzu Chi Med J 2008;20(1):70–72] [Copyright &y& Elsevier]