Clinical value of indocyanine green fluorescence navigation in laparoscopic hepatectomy

Abstract

Abstract: Objective To explore the clinical value of indocyanine green (ICG) fluorescence navigation in laparoscopic hepatectomy (LH). Methods 64 PLC patients admitted to hospital for LH from March 2015 to March 2021 were reviewed, including 40 males and 24 females, with an average age of (56.2±9.8) years. The measurement data of skewness and normal distribution were compared by Mann-Whitney U test and independent t test respectively Counting data were compared by χ² test. Results Among 64 PLC patients, ICG fluorescence navigation was performed in 22 cases (ICG group), and the other 42 cases were non-ICG group. Comparing the clinical data, the operation time of ICG group and non-ICG group was 162 (110, 198) min and 192 (124, 248) min, with statistical significance (P<0.05). The intraoperative blood loss of ICG group and non-ICG group was 102 (36, 214) mL and 208 (98, 402) mL, with statistical significance (P<0.05). There were 21 cases (95.4%) with wide cutting edge (>10 mm) and 1 case (4.5%) with narrow cutting edge (< 10 mm) in ICG group, 31 cases (73.8%) with wide cutting edge and 11 cases (26.2%) with statistical significance (P<0.05). Among 22 patients with ICG fluorescence navigation, 14 were given before operation, which were patients with hepatocellular carcinoma; Intraoperative administration was performed in 8 patients with cholangiocarcinoma. There was no significant difference in clinical data (P>0.05). Bright fluorescence imaging was seen in the tumor area before operation, but no imaging was found in normal liver tissue. After ICG injection, the normal liver tissue showed uniform fluorescence development, but the tumor area did not develop. Conclusion ICG fluorescence navigation is safe and feasible in the application of LH. Defining PLC pathological types before operation is helpful to define tumor margin and accurate surgical navigation: preoperative ICG is selected for hepatocellular carcinoma and intraoperative ICG is selected for cholangiocarcinoma.

Key words: Primary liver cancer, Laparoscopic hepatectomy, Indocyanine green, Fluorescence imaging navigation technology

YAO Han, WANG Jian-dong. Clinical value of indocyanine green fluorescence navigation in laparoscopic hepatectomy[J]. Chinese Hepatolgy, 2021, 26(11): 1272-1275.

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