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Background It is no consensus on the best management for patients with large hepatic hemangiomas. This study was designed to evaluate the efficacy and safety of percutaneous sclerotherapy compared to surgical resection for large hepatic hemangiomas. Methods A total of 89 patients with large hepatic hemangiomas from single center underwent either percutaneous sclerotherapy (n = 14) or surgical resection (n = 75) as first-line treatment was retrospectively studied, followed up for 9–24 months using ultrasound. Terms of intraoperative and postoperative information, postoperative complications, and treatment effectiveness were compared between the two groups. Results Percutaneous sclerotherapy had shorter operative time ( p  &lt; 0.001), less blood loss, lower rate of prophylactic abdominal drainage (97.3% vs. 0%,  p  &lt; 0.001), fewer minor complications (48.0% vs. 7.1%,  p  &lt; 0.01), shorter hospital stay ( p  &lt; 0.001), lower hospital cost ( p  &lt; 0.001), higher Alb level ( p  &lt; 0.001) and lower postoperative clinical index including ALT, AST and WBC ( p  &lt; 0.001 for both) than did surgical resection. The major complications were demonstrated no significant difference between the two groups. In addition, the mean maximum cross-sectional areas of hemangioma dropped from 5044.1 ± 2058.0 mm 2  to 1924.6 ± 1989.5 mm 2  (65.2% reduction) during 9–24 months follow-up ( p  &lt; 0.001) in the percutaneous sclerotherapy group, while all patients in the surgical resection group achieved complete response. Conclusion Percutaneous sclerotherapy is the preferred method for the treatment of large hepatic hemangioma over surgical resection when compared with the items of postoperative recovery, blood loss, complications, hospital stays, and lower hospital costs. The reduction of the maximum cross-sectional area of hepatic hemangioma in the percutaneous sclerotherapy group is satisfactory.

Ultrasound-guided percutaneous sclerotherapy versus surgical resection in the treatment of large hepatic hemangiomas: a retrospective study