After the discovery of hemangioma, the patient’s concern is often how to choose the appropriate treatment —- Is it better to have surgical treatment or to choose non-surgical treatment? If surgical treatment is chosen, what are the precautions to be taken after surgery? This is the next topic we will discuss. Professor Sun Xing pointed out that surgical resection is the most effective method to treat hepatic cavernous hemangioma. For small asymptomatic hemangioma can be treated without treatment and ultrasound examination can be done every 3~6 months. I. Surgical treatment: Indications: Patients with the following conditions can be considered for surgery: 1. Patients smaller than 5cm are not treated and are observed regularly; those over 5-10cm are advocated for surgical resection. 2. Patients with obvious symptoms, usually manifested by obvious discomfort in the right upper abdomen, right lower back, such as nausea, vomiting or even signs of xanthogranuloma. 3.Patients with great stress and anxiety in their hearts, which affect their normal work and life. 4.Liver occupancy that cannot be distinguished from liver malignancy, etc. 5.Patients with benign diseases such as gallbladder stones that are combined with indications for surgery. Surgery: Open surgery can be performed, while laparoscopic resection can be considered for those at the edge of the liver or in the left outer lobe depending on the patient’s specific condition. Among them, laparoscopic hemangioma resection has the advantages of less bleeding, faster postoperative recovery and smaller wounds (described below). Non-surgical treatment (embolization and ablation): 1. Hepatic artery embolization (TAE) TAE treatment for hepatic hemangioma is based on the fact that hepatic hemangioma is mainly supplied by hepatic artery, and thrombus can be formed in the tumor after embolization of artery. Note: While embolization of hemangioma, embolic agents often involve the hepatic portal vessels and normal intrahepatic vessels, causing some serious complications, such as liver necrosis, liver abscess, biliary ischemic stenosis and bile duct arteriovenous fistula. 2, liver hemangioma microwave curing and radiofrequency treatment principle is that microwave can be converted into heat energy and cause the surrounding tissue to coagulate, so that the local shrinkage and hardening of the tumor to achieve the purpose of curing the tumor. Note: The effective diameter of radiofrequency treatment is within 5cm, and it is difficult to ensure complete necrosis around the tumor if it is larger than 5cm. Therefore, radiofrequency is generally used to treat hemangiomas within 5cm. Common postoperative complications: 1. Abdominal hemorrhage: Abdominal hemorrhage is a serious complication after hepatic lobectomy, which mostly occurs within 24h after surgery. It is related to the rich vascularity of liver, and the trauma surface is easy to bleed or bleed; coagulation insufficiency; and ligature thread detachment. 2, liver function impairment and liver pain: patients commonly have liver pain and stuffy discomfort in the liver area after surgery, mostly due to the large amount of intraoperative liver cut or intraoperative hemorrhage and prolonged hepatic portal block, resulting in hepatocyte hypoxia and necrosis. 3, biliary fistula: biliary fistula is manifested by relatively severe abdominal pain in the early postoperative period, and the abdominal drainage tube drains golden bile, mostly leaking from small bile ducts in the liver section. Often accompanied by fever, peritoneal irritation symptoms. 4, pleural effusion: large amount of intraoperative liver cut, postoperative liver function impairment is the main reason for hypoproteinemia; improper placement of drainage tube or premature removal of drainage tube is also one of the reasons. 5.Stress gastric ulcer bleeding: patients with dizziness, weakness and pulse count, indicating bleeding volume above 400ml, such as tarry stools, large and thin volume, active bowel sounds and obvious abdominal distension, suggesting that bleeding is in progress or bleeding is aggravated. 6.Deep vein thrombosis: general anesthesia leads to dilatation of peripheral veins and slowing down of blood flow; surgical trauma causes stressful accumulation of platelet changes, which easily causes deep vein thrombosis of lower limbs. It is easy to lead to pulmonary embolism after deconditioning. Fourth, postoperative care precautions: postoperative fasting is required for 1~3 days, and when the intestinal function is restored and the anus has been exhausted, the gastrointestinal decompression tube is removed. Because of the rich blood flow in the liver, in order to prevent bleeding, the early postoperative period should be quiet bed rest. The amount of activity should be gradually increased according to the condition, and after the condition is stabilized, the patient can get out of bed for appropriate activities to prevent deep vein thrombosis.