To evaluate the safety and efficacy of laparoscopic resection for giant liver hemangioma guided by the concept of enhanced recovery after surgery (ERAS).

Clinical data of 45 patients who underwent ERAS concept-guided laparoscopic resection of giant liver hemangioma in the Second Hospital of Hebei Medical University from November 2015 to October 2021 were retrospectively analyzed. Among them, 23 patients were male and 22 female, aged (57±10) years on average. The diameter of liver hemangioma was (13.1±2.3) cm. 11 patients were classified as type Ⅰc, 28 cases of type Ⅱb and 6 cases of type Ⅱc. The informed consents of all patients were obtained and the local ethical committee approval was received. Perioperatively, ERAS protocol was adopted to promote the recovery of patients, and perioperative conditions of patients were observed.

All patients successfully completed the surgery without conversion to open surgery. No postoperative bleeding, bile leakage or other severe complications occurred. No perioperative death was observed. The operation time was (162±45) min. 45 patients received occlusion of the porta hepatis and the occlusion time was (32±5) min. The median intraoperative blood loss was280 (200, 353) ml. Intraoperative blood transfusion was performed in 11 cases, and the the largest transfusion amount was 4 U suspended red blood cells. The gastric and abdominal drainage catheters were removed at postoperative 1 d. The first anal exhaust time was (1.1±0.3) d. At postoperative 1 d, the visual analogue scale (VAS) pain score was 2.8±0.7. The length of postoperative hospital stay was (5.3±0.5) d. The hospitalization expense was (4.6±0.4)×10⁴ yuan. Liver function indexes were restored to normal at postoperative 5-10 d. No recurrence of hemangioma was found during the postoperative follow-up.

ERAS concept-guided laparoscopic resection of giant liver hemangioma is safe and feasible, which yields slight trauma and accelerates postoperative recovery.