Objective  To report successful surgical resection of a giant hepatic hemangioma.

  Methods  A giant hepatic hemangioma measured 35 cm in diameter, and the weight was 12.5 kg. Three-dimensional visualization technology was used preoperatively to develop an accurate surgical plan. Several surgical techniques were performed during the operation, including cessation of the right hepatic artery to promote autologous blood transfusion in the hemangioma, maintenance of low central venous pressure to reduce the blood loss, and cessation of the inflow first, followed by the outflow.

  Results  The operation was successfully performed in 3 hours; intraoperative blood loss was minimal, and the patient recuperated well.

  Conclusions  By using a preoperative three-dimensional technique and inflow-first approach and by maintaining low venous pressure, a giant hepatic hemangioma can be safely and successfully removed.