Xu L, Gao RZ, Dong SY, Kong J, Yao CY, Wu SL, Ke S, Zhou ZT, Gao J, Wang SH. Efficacy and safety of thermal ablation for large hepatic caudate lobe hemangioma. World J Gastrointest Surg 2026; 18(10): 122889 [DOI: 10.4240/wjgs.122889]
Corresponding Author of This Article
Shao-Hong Wang, PhD, Professor, Division of Hepatobiliary Surgery, Department of General Surgery, Beijing Chaoyang Hospital Affiliated to Capital Medical University, No. 5 Jingyuan Road, Shijingshan District, Beijing 100043, China. shaohong.wang@ccmu.edu.cn
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Gastroenterology & Hepatology
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research-article
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Xu L, Gao RZ, Dong SY, Kong J, Yao CY, Wu SL, Ke S, Zhou ZT, Gao J, Wang SH. Efficacy and safety of thermal ablation for large hepatic caudate lobe hemangioma. World J Gastrointest Surg 2026; 18(10): 122889 [DOI: 10.4240/wjgs.122889]
World J Gastrointest Surg. Oct 27, 2026; 18(10): 122889 Published online Oct 27, 2026. doi: 10.4240/wjgs.122889
Efficacy and safety of thermal ablation for large hepatic caudate lobe hemangioma
Li Xu, Rui-Ze Gao, Shu-Ying Dong, Jian Kong, Chang-Yu Yao, Shi-Lun Wu, Shan Ke, Zhi-Ting Zhou, Jun Gao, Shao-Hong Wang
Li Xu, Rui-Ze Gao, Shu-Ying Dong, Jian Kong, Chang-Yu Yao, Shi-Lun Wu, Shan Ke, Jun Gao, Shao-Hong Wang, Division of Hepatobiliary Surgery, Department of General Surgery, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing 100043, China
Zhi-Ting Zhou, Alberta Institute, Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
Co-first authors: Li Xu and Rui-Ze Gao.
Co-corresponding authors: Jun Gao and Shao-Hong Wang.
Author contributions: Gao J and Wang SH designed and conducted the study, have played important and indispensable roles in the experimental design, data interpretation and manuscript preparation as the co-corresponding authors; Xu L and Gao RZ wrote the paper, have made crucial and indispensable contributions towards the completion of the project and thus qualified as the co-first authors of the paper; Zhou ZT contributed to the analysis; Dong SY, Kong J, Yao CY, Wu SL and Ke S were responsible for data curation; Wang SH supervised the study.
AI contribution statement: No AI tool was involved in the generation of research data, interpretation of results, or formulation of conclusions.
Supported by Beijing Natural Science Foundation, No. 7222069.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of Beijing Chaoyang Hospital.
Informed consent statement: Written informed consent was obtained from all participants.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at shaohong.wang@ccmu.edu.cn.
Corresponding author: Shao-Hong Wang, PhD, Professor, Division of Hepatobiliary Surgery, Department of General Surgery, Beijing Chaoyang Hospital Affiliated to Capital Medical University, No. 5 Jingyuan Road, Shijingshan District, Beijing 100043, China. shaohong.wang@ccmu.edu.cn
Received: May 8, 2026 Revised: June 14, 2026 Accepted: June 30, 2026 Published online: October 27, 2026 Processing time: 164 Days and 12.9 Hours
Abstract
BACKGROUND
For large hepatic hemangiomas in the caudate lobe, surgical resection is difficult and risky; a clinical gap remains in effective minimally invasive alternatives.
AIM
To investigate the safety and efficacy of thermal ablation for hepatic caudate lobe hemangioma.
METHODS
This retrospective single-arm study enrolled 16 patients with 16 large hepatic caudate lobe hemangiomas treated by thermal ablation from April 2017 to January 2025. Safety and efficacy were evaluated. Six Spiegel lobe lesions underwent laparoscopic microwave ablation (MWA), two with intratumoral resection after MWA-induced coagulation. Three caudate process lesions received computed tomography-guided radiofrequency ablation (CT-RFA). Of seven paracaval lesions, five underwent laparoscopic MWA and two CT-RFA.
RESULTS
The technical success and radiologic response were achieved in all 16 patients (100%). All 5 symptomatic patients achieved symptom relief. No major complications occurred; minor events (Society of Interventional Radiology class A) included self-limited postoperative fever (n = 2) and transient hemoglobinuria (n = 1), all resolving within 72 hours. The median ablation time was 113 min [interquartile range (IQR): 30-135]. The median intraoperative blood loss was 10 mL (IQR: 0-23). No patient received blood transfusions during or after the operation. The median postoperative hospital stay was 3 days (IQR: 2-4). The complete ablation rate was 86%. At a median follow-up of 21 months (IQR: 15-33), no tumor progression or recurrence was observed. The mean diameter of the ablated zone decreased significantly.
CONCLUSION
With an integrated strategy, thermal ablation for hepatic caudate lobe hemangiomas is a safe, feasible, and effective minimally invasive therapeutic modality.
Core Tip: Thermal ablation using an integrated strategy (laparoscopic and computed tomography-guided approaches with microwave or radiofrequency ablation) is a safe, feasible, and effective minimally invasive treatment for large hepatic caudate lobe hemangiomas, achieving 100% technical success and clinical response rates with only minor, self-limited adverse events.
