Clinical application of transcatheter arterial embolization followed by laparoscopic hepatectomy for giant hepatic hemangioma

LI Xin-ci; ZENG Xiao-jun; CHEN Hong-bing; TAO Hai-su; ZHU Wen; YANG Jian

doi:10.19538/j.cjps.issn1005-2208.2024.04.20

Abstract：Objective To explore the feasibility of transcatheter arterial embolization(TAE)followed by laparoscopic hepatectomy in the treatment of giant hepatic hemangioma.Methods Forty-two patients with giant hepatic hemangioma who had been hospitalized during the period from January 2022 to November 2023 in our center were analyzed.According to different treatment methods,they were divided into two groups,whereby 19 cases in the delayed surgery group were treated with TAE and delayed laparoscopic hepatectomy,while 23 cases in the one-stage surgery group were treated with laparoscopic hepatectomy.The tumor diameters before laparoscopic surgery or TAE,the operation characteristics,and short-term complications of the two groups were compared and analyzed.Results After TAE treatment,the tumor diameters of the delayed surgery group were significantly decreased((15.1±3.0)cm vs.(11.2± 2.5)cm,P＜0.001).The operation time(240(180-270)min vs.300(240-360)min,P=0.035),intraoperative blood loss(100(80-100)mL vs.180(100-400)mL,P=0.024),and the postoperative hospital stay(7(5-8)d vs.8(7-9)d,P=0.049)in the delayed surgery group were significantly lower than in the one-stage surgery group.The postoperative serum levels of the hepatic function index were not statistically different between the two groups.There was no significant difference in the incidence of Clavien-Dindo complications and postoperative complications.Conclusion Transcatheter arterial embolization followed by laparoscopic hepatectomy in the treatment of giant hepatic hemangioma is not only safe and effective,but can also promote the early discharge of patients and simplify the operative procedures,which provides a new train of thought for the treatment of giant hepatic hemangioma.