Advancements in hepatic haemangioma surgery: An update-review of protocols, techniques, and postoperative outcomes

Abstract

Hepatic haemangiomas are the most common benign liver lesions, often found on incidental imaging. Although often asymptomatic, they can lead to abdominal pain, bleeding and rarely rupture. Surgery is indicated in symptomatic cases or in case of complications. To evaluate current surgical management strategies for hepatic haemangiomas, focusing on recent advances in minimally invasive and robotic surgery, imaging, embolization, and perioperative care. It also explores the emerging role of artificial intelligence (AI) in preoperative planning, intraoperative guidance, and postoperative monitoring, and proposes evidence-based management algorithms reflecting current practice and future directions. This minireview synthesizes the recent literature on the surgical management of hepatic haemangiomas, with emphasis on advances in surgical strategies, perioperative protocols available to date, and postoperative care. The contemporary role of diagnostic imaging and AI in improving preoperative evaluation is also explored. Advances in minimally invasive techniques, improved intraoperative navigation and improved recovery protocols have significantly reduced surgical morbidity. The integration of AI has improved lesion characterization and surgical planning. Current surgical procedures, such as laparoscopic incision and robot-assisted resections, have demonstrated favorable outcomes in selected patients.

Keywords: Hepatic haemangioma; Liver haemangioma; Liver surgery; Hepato-pancreatο-biliary surgery; Artificial intelligence

Core Tip: Hepatic haemangiomas are common benign liver lesions that typically require surgery only when symptomatic or complicated. Recent progress in minimally invasive and robotic techniques, enhanced intraoperative guidance, and optimized recovery pathways has significantly improved surgical safety and outcomes. Meanwhile, artificial intelligence is emerging as a valuable tool for precise lesion assessment and individualized surgical planning. Continued refinement of patient selection and standardized perioperative protocols will be key to maximizing treatment effectiveness.