Clinical investigation of surgical resection for hepatic hemangioma

Objective To discuss the selection of surgical procedure, the curative effect and the safety of resection for hepatic hemangioma. Methods Clinical data of 96 patients with pathologically confirmed hepatic hemangioma who received resection in the People's Hospital of Qinghai Province from January 2000 to December 2011, were analyzed retrospectively. There were 34 males and 62 females with the age of 28 to 67 years old and the median age of 47 years old. There were 69 patients with single lesion and 27 patients with multiple lesions. The informed consents of all patients were obtained and the ethical committee approval was received. The patients received resection of hepatic hemangioma, or segmental hepatectomy, lobectomy, hemihepatectomy and hepatic hemangioma ligation. The procedure, intraoperative bleeding, postoperative complications and recurrence were observed. Patients were followed up after being discharged from hospital and liver ultrasonography was applied to check whether there was hemangioma recurrence. Results All the patients underwent operation successfully without perioperative death. Of the 96 patients, 68 patients received resection of hepatic hemangioma, 3 patients underwent right hemihepatectomy, 1 patient underwent left hemihepatectomy, 5 patients underwent hepatic caudate labectomy, and 19 patients underwent segmental hepatectomy; 27 patients with multiple lesions underwent resection of major lesions firstly and then the smaller lesions were ligated. The median of intraoperative bleeding was 630(60-5700)ml. Pleural effusion was observed in 9 patients, bile leakage in 3 cases, subphrenic hydrops in 2 cases and incision infection in 1 case. All the patients were cured by conservative treatment. Sixty-nine patients were followed up for 1-3 years and no hemangioma recurrence was found. Conclusions Surgical resection is a safe and effective treatment for hepatic hemangioma, in which hemangioma resection is the most common approach. Liver hemangioma ligation is usually performed to deal with the smaller lesions in patients after the major lesions are resected. Key words: Hemangioma, cavernous; Liver neoplasms; Hepatectomy; Suture techniques