Abstract: Objective To investigate the effect of indocyanine green (ICG) on the choice of surgical treatment for patients with primary small hepatocellular carcinoma. Methods A retrospective analysis of 108 patients with small hepatocellular carcinoma who were treated in our hospital from February 2015 to February 2018 was conducted. Among these patients, 52 patients underwent hepatectomy (hepatectomy group) and 56 patients underwent radiofrequency ablation (RFA) therapy (RFA group). The preoperative and postoperative liver function data were collected and patients were classified into hepatic failure group and non-hepatic failure group according to whether liver failure occurred. Results There was no significant difference in gender, age, body mass index, aspartate aminotransferase, alanine aminotransferase, total bilirubin, albumin, Child-Pugh (CP) score and ICG between hepatectomy group and RFA group (P>0.05). The maximum diameter of the tumor in hepatectomy group was significantly higher than that in RFA group (5.2±2.1 cm vs 2.3±2.0 cm, P<0.05). Liver failure occurred in 9 patients and 6 patients in the hepatectomy group and the RFA group, respectively. The CP scores of patients with liver failure were significantly higher than those of patients without liver failure in both hepatectomy and RFA group (8.5±1.0, 8.6±1.1 vs 5.5±0.8, 5.7±0.6, P<0.05). And ICGs were the same (31.2±17.5 %, 38.5±13.5 % vs 13.4±8.6%, 14.2±7.5%, P<0.05). In addition, there were significant differences in the ICG-retention rate at 15 minutes and liver function grading between patients with hepatic failure and non-hepatic failure in hepatectomy and RFA group (P<0.05). Conclusion Hepatectomy and RFA are safe treatment of small hepatocellular carcinoma. The ICG test has limited value in the selection of hepatectomy or RFA, but it has a high evaluation value in predicting postoperative liver failure.

Key words: Small hepatocellular carcinoma, Indocyanine green, Hepatectomy, Radiofrequency ablation