Are you still having open surgery for liver hemangioma?

  With the improvement of people’s living standards, medical checkups have become an annual necessity for many people, and with them, various diseases that do not easily cause discomfort have entered people’s view, of which hepatic hemangioma is a typical representative.  Hepatic hemangiomas are the most common benign tumors of the liver, occurring between the ages of 30 and 50, and are more common in women.  Hepatic hemangiomas usually occur in childhood and are found during adult physical examinations and are usually solitary, or in a few cases, multiple. Hepatic hemangiomas are usually asymptomatic, especially when they are small. When the partial hepatic hemangioma is larger or grows to the edge of the liver, symptoms such as persistent vague abdominal pain, postprandial fullness, indigestion, etc. may occur and can be life-threatening if it ruptures and bleeds spontaneously or if external impact causes bleeding.  In fact, in recent years, minimally invasive treatment for hepatic hemangioma has developed very rapidly, and the representative interventional treatment for hepatic hemangioma is gradually being promoted and applied, and it can be carried out skillfully in many tertiary hospitals in China, and has become one of the common clinical treatment methods. Interventional treatment of hepatic hemangioma is mainly divided into two kinds, one is selective hepatic artery embolization, and the other is direct percutaneous puncture sclerotherapy and drug injection.  Selective hepatic artery embolization refers to piercing a rice-sized opening with a needle in the femoral artery, then operating a catheter through it to the blood supply artery of hepatic hemangioma, and then embolizing the blood supply artery while injecting drugs into the hepatic hemangioma through the catheter. The purpose of treatment is to reduce the size of the tumor. Direct percutaneous puncture percutaneous puncture sclerotherapy and drug injection treatment is to insert the needle directly into the hepatic hemangioma under the guidance of B ultrasound or CT, and then inject the sclerosing agent directly into the tumor, so that the tumor tissue will be fixed by dehydration and the cell protein will be coagulated and denatured, which will lead to necrosis and fibrosis of the tumor and slowly shrink and absorb, thus achieving the treatment purpose.  The most important features of these two types of minimally invasive treatment for hepatic hemangioma are: small trauma: the small puncture opening only needs to be disinfected, and then a band-aid is applied to it. hospital for a few more days, and both methods can achieve this goal. A few days of postoperative liver protection drugs are usually sufficient, and the patient can be discharged soon. Low risk: Both techniques are relatively mature and are routinely performed in many tertiary care hospitals, with very low risk. To put it in layman’s terms, if you want open surgery for hepatic hemangioma, you probably have to find a senior, fairly experienced chief of surgery to do it, whereas if it’s an intervention, then you’re looking for a generally responsible attending physician!  Of course, hepatic hemangioma is a benign tumor, not all of which must be treated. Treatment can be considered in the following cases: 1.hepatic hemangioma larger than 5cm, with obvious pressure symptoms or pain; 2.hepatic hemangioma adjacent to the liver envelope, with the risk of rupture; 3.hepatic hemangioma has ruptured and bleeding (this must be done, interventional embolization to stop bleeding is very effective); 4.unable to open resection or unwilling to accept open treatment; 5.hepatic hemangioma found to increase rapidly for a short time during regular review.