Safety and feasibility of laparoscopic resection for giant hepatic hemangiomas: a retrospective cohort study

Giant hepatic hemangiomas can cause significant symptoms or complications, and laparoscopic resection remains technically demanding. This study assessed the safety and feasibility of laparoscopic resection for giant hemangiomas. A retrospective review was conducted of all patients undergoing laparoscopic resection (LR) for giant hepatic hemangiomas between July 2021 and April 2025 at a single tertiary center. Surgical indication was based on the presence of clinically relevant symptoms reasonably attributable to the hemangioma, after exclusion of alternative causes.In selected symptomatic patients, documented tumor growth (>1 cm/year) and unfavorable anatomical location, particularly proximity to major hepatic vessels, were considered supportive factors rather than independent indications for surgery.Demographic, operative, and postoperative data were analyzed. Outcomes were compared by tumor location (left vs right hepatic lobe) using the Mann–Whitney U test, with effect sizes expressed as Hodges–Lehmann median differences. Eighteen patients (83% female; median age 52 years) underwent laparoscopic resection with no conversions to open surgery. Median tumor size was 100 [IQR 90–140]. Median operative time was 227.5 [IQR 181.25–262.5], median blood loss 400 [IQR 325–575] and hospital stay 4.5 [IQR 4.0–5.0]. One minor postoperative complication classified as Clavien–Dindo grade II was observed. There were no major complications and no 90-day mortality. Operative time was significantly longer for right-lobe tumors (median 238 min [IQR 217–298]) vs left-lobe tumors (173 min [IQR 156–215]; Hodges–Lehmann difference 70 min, 95% CI 0–140; p = 0.049). Blood loss was higher in the right-lobe group (median 450 vs 350 ml), but this did not reach significance (p = 0.20). No recurrences were observed during follow-up (median 10 months). Laparoscopic resection of giant hepatic hemangiomas appeared to be feasible and safe in selected patients in this single-center experience. Right-lobe tumors were associated with longer operative times, reflecting greater technical complexity.