To investigate surgical strategy and clinical efficacy of laparoscopic surgery for giant hepatic hemangioma.

Clinical data of 32 patients with giant hepatic hemangioma who underwent laparoscopic surgery in the First Affiliated Hospital of Shenzhen University from January 2017 to May 2021 were retrospectively analyzed. Among them, 13 patients were male and 19 female, aged (41±8) years on average. Preoperative liver function of all patients was classified as Child-Pugh A. ICGR15 was 0.043±0.004. The diameter of hepatic hemangioma was (11.6±1.2) cm. 23 cases were classified as type Ⅰc, 6 cases of type Ⅱb and 3 cases of type Ⅱc. The informed consents of all patients were obtained and the local ethical committee approval was received. The incidence of intraoperative and postoperative complications was observed.

28 patients successfully underwent laparoscopic surgery, including 10 cases of hepatic hemangioma dissection, 7 cases of non-anatomical resection and 11 cases of anatomical resection.4 cases were converted to open surgery. The laparoscopic operation time was (168±7) min and the median intraoperative blood loss was 240(50-420) ml. Intraoperative blood transfusion was performed in 3 cases. 23 patients with single giant type Ⅰc hemangioma mainly underwent hepatic hemangioma dissection. In9 cases with multiple type Ⅱ hemangioma, the main tumor with the largest diameter was dissected or resected primarily. 11 patients with the main tumor located in the left liver lobe received anatomical hepatectomy,5 cases with the main tumor located in the right liver lobe and 3 cases with the main tumor located in the left lobe received non-anatomical hepatectomy, and the remaining 13 cases with the main tumor deeply located or adjacent to vital anatomical sites underwent hepatic hemangioma dissection. The length of postoperative hospital stay was (7.3±1.9) d. 4 patients developed postoperative complications including bile leakage in 1 case and pleural effusion in 3 cases, and all were cured after drainage. No recurrence of hepatic hemangioma was noted during postoperative follow-up.

Laparoscopic surgery is a safe and efficacious procedure for giant hepatic hemangioma, which yields slight trauma and prompt recovery. Proper surgical methods should be selected according to the classification and location of hemangioma. Active interventions should be delivered to prevent the intraoperative bleeding and guarantee the safety of surgery.