Diagnosis And Therapy Of Hepatic Hemangioma

Objective:Clarify the surgical indications of hepatic hemangioma,and compare the difference of surgery effect between enucleation hepatichemagioma and hepatectomy.Method:The medical records of 156 hepatic hemangioma patients in Hepatopancreatobiliary Surgery Department of The First Affiliated Hospital of Fujian Medical University from January 2013 to October 2018 were retrospectively analyzed,with 59 cases undergoing enucleation of hepatic hemagioma and 85 cases undergoing hepatectomy.Age,gender,tumor size(cm),tumor number,tumor location,duration of the first hepatic hilum occlusion,intraoperative blood loss(ml),intraoperative blood transfusion volume(ml),postoperative complications and length of postoperative hospital stay(d)were compared between two groups.Result:There was no statistically significant difference between two groups in age,gender,tumor size,postoperative complications,intraoperative blood loss and intraoperative blood transfusion volume(P>0.05).The difference in tumor location,tumor number,duration of the first hepatic hilum occlusion and length of postoperative hospital stay between two groups was statistically significant(P<0.05),hepatectomy is superior to enucleation of hepatic hemagioma in terms of the first hilum occlusion time and postoperative hospital stay.Conclusion:Firstly,hepatectomy and enucleation of liver hemangioma are both mainstream procedures for the surgical treatment of liver hemangioma,the choice depends largely on the location of the tumor,age,gender,tumor size and number of patients may not be the influencing factors of the choice of hepatic hemangioma surgery.Secondly,indications of operation:1.The diameter of tumor is greater than or equal to 4 centimeters,accompanied by obvious symptoms and other causes were excluded.2.The tumor is greater than or equal to 10 cm in size and nearly 1/2 of the tumor protrude extrahepatic.3.There is a pull on the liver capsule when the tumor is under the liver capsule,or the tumor is located at the edge of the liver,or continuous growth of the tumor near the first and second hepatic hilum may infringe and compress blood vessels.4.Constricting the adjacent organs such as stomach and du-odenum.5.Complicated with Kasabach-Merritt Syndrome,Budd-Chiari Syndrome,hepatic hemangioma rupture and hemorrhage with or without infection and other complications,or with high risk factors of tumor rupture and hemorrhage,such as extreme sports enthusiasts,pregnant women and drivers.6.With heavy psychological burden,and a strong desire for the operation.7.Regardless of tumor size,all cases with following situations should be actively treated:the diagnosis is unidentified or cannot exclude liver cancer to diagnose,hepatitis B surface antigen-positive,previous history of hepatitis B,family history of liver cancer,liver cirrhosis,abnormal increase in AFP et al.8.Benign diseases of the upper abdomen(such as gallbladder stones)should be treated together with surgery.9.During the follow-up,the tumor grows progressively and rapidly.