Clinical effects of the use of the indocyanine green fluorescence imaging technique in laparoscopic partial liver resection

Shinji Itoh, Takahiro Tomiyama, Akinari Morinaga, Takeshi Kurihara, Yoshihiro Nagao, Takeo Toshima, Kazutoyo Morita, Noboru Harada, Masaki Mori, Tomoharu Yoshizumi, Shinji Itoh, Takahiro Tomiyama, Akinari Morinaga, Takeshi Kurihara, Yoshihiro Nagao, Takeo Toshima, Kazutoyo Morita, Noboru Harada, Masaki Mori, Tomoharu Yoshizumi

Abstract

Aim: This study aimed to clarify the clinical effects of the indocyanine green (ICG)-fluorescence imaging (FI) technique for determination of liver transection lines during laparoscopic partial liver resection for liver tumors.

Methods: This was a retrospective study including 112 patients who underwent laparoscopic partial liver resection for liver tumors. These enrolled patients were divided into an ICG-FI group (n = 55) and a non-ICG-FI group (n = 57) according to the availability of the ICG-FI. The clinicopathological characteristics of patients between two groups were compared before and after propensity score matching.

Results: The ICG-FI and non-ICG-FI groups differed at baseline in terms of ICG retention rate at 15 min. After propensity score matching, two comparable groups of 32 patients each were obtained. The negativity rated of the pathological surgical margins were comparable between the two groups before and after propensity score matching. However, the surgical margins were significantly wider in the ICG-FI group before and after propensity score matching (P = .039 and P = .047, respectively).

Conclusion: The ICG-fluorescence imaging technique may offer clinical benefits in terms of a secure surgical margin in laparoscopic partial liver resection.

Keywords: indocyanine green fluorescence imaging; laparoscopic partial liver resection.

© 2022 The Authors. Annals of Gastroenterological Surgery published by John Wiley & Sons Australia, Ltd on behalf of The Japanese Society of Gastroenterology.

Figures

FIGURE 1
FIGURE 1
Observation of the resected surface using indocyanine green (ICG)‐fluorescence imaging during laparoscopic liver transection. (A) Normal laparoscopic image. (B) Fluorescence image
FIGURE 2
FIGURE 2
Laparoscopic partial liver resection using indocyanine green (ICG)‐fluorescence imaging. (A) Colorectal liver metastasis in segment 8. Hepatic transection line based on intraoperative ultrasonography and fluorescence imaging of the tumor. (B) Surgical specimen shown with normal laparoscopic color image. (C) Fluorescence image of the surgical specimen. (D) Hepatocellular carcinoma in segment 6. Normal laparoscopic color image. (E) Fluorescence image. (F) Normal image of the surgical specimen. (G) Fluorescence image of the surgical specimen

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