Safety and feasibility analysis of ICG fluorescence imaging laparoscopic anatomical right hepatectomy in the treatment of liver neoplasms / 中国实用外科杂志

ABSTRACT

OBJECTIVE: To explore the safety and feasibility of ICG fluorescence fusion technique in the treatment of liver neoplasms by laparoscopic anatomical right hepatectomy.METHODS: A retrospective study was conducted to enroll 108 patients with hepatic malignancies admitted to the Department of Hepatobiliary Surgery in the People's Hospital of Hunan Province from January 2016 to December 2018.The clinical data of the patients were collected.The patient's residual liver volume was calculated before surgery,and a liver function reserve test was performed to evaluate the patient's tolerance to laparoscopic right hepatectomy.According to whether indocyanine green fusion imaging technique was performed during intraoperative laparoscopic surgery,all patients were divided into two groupsfluorescent laparoscopic anatomical right hepatic group(experimental group)and non-fluorescent laparoscopic anatomical right hepatectomy group(control group).Intraoperative and postoperative clinical data of patients in both groups were compared and analyzed.Data were reported in the form of mean ± standard deviation for numerical variables and n(%)for categorical variables.RESULTS: There were 108 patients undergoing laparoscopic anatomical right hepatectomy,including 24 patients in the experimental group and 84 patients in the control group.Three patients stained failed in the experimental group,of which 1 patient failed for forward staining method and 2 patients failed for reverse staining method.Intraoperatively,compared with the control group,the operation time of the experimental group[(274.58±42.12)min vs.(303.99±54.67)min,(P0.05)]had no significant difference between the two groups.Postoperatively,there was no significant difference in hospitalization time,tumor diameter and the incidence of lung infection,hemorrhage and bile leakage between the two groups(P>0.05).CONCLUSION: ICG fluorescence imaging laparoscopic anatomical right hepatectomy is helpful for the confirmation of intraoperative hepatic plane,thus reducing the operation time and hepatic occlusion time.It can be used for the detection of intraoperative bile leakage.The development of ICG fluorescence fusion technology is conducive to the promotion of laparoscopic anatomical right hepatectomy.Under strict conditions,it can effectively improve the controllability and safety of laparoscopic anatomical right hepatectomy.