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Surgical Endoscopy

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15-04-2024 | Cavernous Liver Hemangioma

Laparoscopic liver resection or enucleation for giant hepatic hemangioma: how to choose?

Authors: Haili Zhang, Hongwei Xu, Ningyuan Wen, Bo Li, Kefei Chen, Yonggang Wei

Published in: Surgical Endoscopy | Issue 6/2024

Abstract

Background

Laparoscopic treatment has been increasingly adopted for giant hepatic hemangioma (HH), but the role of liver resection or enucleation remains uncertain. The aim of this study is to compare the laparoscopic resection (LR) with laparoscopic enucleation (LE) for HH, and to provide evidence on how to choose the most suitable approach for HH.

Methods

A retrospective analysis of HH patients underwent laparoscopic treatment between March 2015 and August 2022 was performed. Perioperative outcomes were compared based on the surgical approaches, and risk factors for increased blood loss was calculated by logistic regression analysis.

Results

A total of 127 patients in LR group and 287 patients in LE group were enrolled in this study. The median blood loss (300 vs. 200 mL, P < 0.001) was higher in LE group than that in LR group. Independent risk factors for blood loss higher than 400 mL were tumor size ≥ 10 cm, tumor adjacent to major vessels, tumor occupying right liver or caudate lobe, and the portal phase enhancement ratio (PER) ≥ 38.9%, respectively. Subgroup analysis showed that LR was associated with less blood loss (155 vs. 400 mL, P < 0.001) than LE procedure in patients with high PER value. Both LR and LE approaches exhibited similar perioperative outcomes in patients with low PER value.

Conclusions

Laparoscopic treatment for HH could be feasibly and safely performed by both LE and LR. For patients with PER higher than 38.9%, the LR approach is recommended.

Graphical abstract

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Title: Laparoscopic liver resection or enucleation for giant hepatic hemangioma: how to choose?
Authors: Haili Zhang
Hongwei Xu
Ningyuan Wen
Bo Li
Kefei Chen
Yonggang Wei
Publication date: 15-04-2024
Publisher: Springer US
Keywords: Cavernous Liver Hemangioma
Liver Resection
Liver Resection
Published in: Surgical Endoscopy / Issue 6/2024
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-024-10820-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Laparoscopic liver resection or enucleation for giant hepatic hemangioma: how to choose?

Abstract

Background

Methods

Results

Conclusions

Graphical abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Graphical abstract

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