On July 1, the Department of Hepatobiliary Surgery of the Second Hospital of Shandong University performed total laparoscopic resection for a patient with massive hepatic hemangioma, and successfully saved the gallbladder close to the tumor. The operation was performed by Li Tao, the deputy dean of the Hospital and chief physician. It took only 2 hours, with less invasion and good postoperative recovery.
Hepatic hemangioma is a type of benign tumor caused by the abnormal development of hepatic blood vessel structure. Massive hemangioma is like a time bomb inside the human body, and once it is subject to external force, it can easily rupture, causing massive hemorrhage and even endangering life. The traditional surgical method for treating hepatic hemangioma is laparotomy, which will leave a 20-25cm scar on the abdomen, with large invasion and slow recovery. Laparoscopic resection of massive hepatic hemangioma has the advantages of fewer invasions and less bleeding volume, but due to limited vision and exposure, the operation is difficult with a high risk of bleeding, which poses high requirements for the surgical team. During the operation, the tumor with extremely rich blood supply should be completely resected, and the normal liver tissue should be preserved to the maximum level, which requires superb surgical skills and the ability to flexibly handle the actual situation on site.
The patient was a middle-aged woman who was admitted to the Second Hospital of Shandong University due to abdominal discomfort and massive hepatic hemangioma found in physical check. After examination, it was found that the diameter of the patient's hepatic hemangioma was bigger than 10CM, with indications for surgery, and necrosis had appeared in the center of the tumor, which was close to the first porta hepatis and near the great vessels and biliary tract. After careful discussion and preparation, and thorough communication with the patient and family members, Li Tao, Wu Lingtong, chief physician of the Department, and Tian Gendong, associate chief physician of the Department, decided to perform laparoscopic resection for the patient.
Early in the morning on July 1, Li Tao led chief physicians Li Xiaoming and Lv Qigang from the Hepatobiliary Surgery Team, with the support of the Second Department of Anesthesiology and the Second Operation Department, successfully completed the laparoscopic segmental hepatectomy. While ensuring the complete resection of the hemangioma, they successfully saved the gallbladder close to the tumor, and preserved the size and function of the liver to the maximum level. The operation took only 2 hours, with about 100ml of bleeding volume. The patient returned to the ward safely after surgery.
Hepatic hemangioma can grow in any place of the liver, and multiple hepatic hemangiomas are also very common, with the diameter ranging from only a few millimeters to dozens of centimeters, covering abdominal cavity and pelvic cavity. When the diameter of the hepatic hemangioma is less than 5 cm, patients normally feel nothing, so it is difficult to be detected. If the hemangioma is too large, or when the peripheral gastrointestinal and other organs are compressed, there will be liver discomfort, loss of appetite, postprandial fullness or belching, nausea, indigestion, jaundice and other symptoms. Large tumors near the surface of the liver or tumors with thin capsular walls may rupture and bleed due to external forces, which is very dangerous. At present, the most advanced surgical method is laparoscopic hemangioma resection or partial segmental hepatectomy or partial hepatic lobectomy.
Adhering to the concept of "minimally invasive", the Department of Hepatobiliary Surgery has been routinely carrying out major and complex hepatobiliary surgeries for liver, biliary tract, pancreas, spleen and others. The Department’s surgical operation capacity is among the top in the province and it has benefited patients with hepatobiliary-pancreatic-splenic diseases in Shandong Province.
Li Tao, the chief physician and doctoral supervisor, specializes in the treatment of cholangiocarcinoma, liver cancer, gallstone, gallbladder polyp, obstructive jaundice, pancreatic cancer, vater ampulla carcinoma, hepatic hemangioma, portal hypertension and other diseases. His outpatient time: every Friday morning.
{Author: Li Xiaoming Lin Yu Source: Department of Hepatobiliary Surgery Edited by: Publicity Department/News Center}