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Here we provide a systematic review of hepatic ectopic pregnancies and the corresponding management strategies. Furthermore, this report details a case of ectopic hepatic pregnancy, successfully treated with primary methotrexate (MTX) followed by a two-staged robotic-assisted resection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Two independent investigators performed a systematic review using the online search engine PubMed and MEDLINE database. The search utilized the following terms: \u2018Hepatic Ectopic Pregnancy,\u2019 \u2018Hepatic Extrauterine Pregnancy,\u2019 \u2018Hepatic Abdominal Pregnancy,\u2019 and \u2018Ectopic Liver Pregnancy.\u2019 Cross-referencing was employed to identify possible additional publications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>Forty-seven case reports on hepatic pregnancies were identified. Of these, 40 provided manuscripts in the English language. Most patients with hepatic pregnancy presented with mild to moderate abdominal pain, while only a minority exhibited signs of hemodynamically relevant intraperitoneal hemorrhage. Most cases were managed through open surgical removal, although in recent years, there has been an increase in laparoscopically managed cases. Conservative approaches using methotrexate are seldom employed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Hepatic pregnancies present a rare and challenging clinical scenario. Until now, these cases have usually been treated primarily with open explorative surgery. As reported in this case, primary conservative treatment approaches with MTX before surgery hold promise as a strategy to reduce surgery-related bleeding and morbidity, particularly for asymptomatic or oligosymptomatic patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00404-024-07739-0","type":"journal-article","created":{"date-parts":[[2024,10,1]],"date-time":"2024-10-01T05:01:58Z","timestamp":1727758918000},"page":"2345-2353","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Multimodal management of ectopic hepatic pregnancy: a systematic review of the literature"],"prefix":"10.1007","volume":"310","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0400-0046","authenticated-orcid":false,"given":"Maximilian Heinz","family":"Beck","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jalid","family":"Sehouli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonas Alexander","family":"Leppig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Knitter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johann","family":"Pratschke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix","family":"Krenzien","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,10,1]]},"reference":[{"issue":"1","key":"7739_CR1","first-page":"34","volume":"90","author":"JH Barash","year":"2014","unstructured":"Barash JH, Buchanan EM, Hillson C (2014) Diagnosis and management of ectopic pregnancy. 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