Application Effect of ICG Fluorescence Real-Time Imaging Technology in Laparoscopic Hepatectomy

Hao Chen, Yumin Wang, Zhiguo Xie, Luyuan Zhang, Yongsheng Ge, Jihai Yu, Chuanhai Zhang, Weidong Jia, Jinliang Ma, Wenbin Liu, Hao Chen, Yumin Wang, Zhiguo Xie, Luyuan Zhang, Yongsheng Ge, Jihai Yu, Chuanhai Zhang, Weidong Jia, Jinliang Ma, Wenbin Liu

Abstract

This study aimed to evaluate the efficiency and safety of indocyanine green (ICG) fluorescence real-time imaging-guided technology in laparoscopic hepatectomy. A retrospective analysis of patients with primary liver cancer in the First Affiliated Hospital of USTC from January 2018 to October 2021, including 48 cases of fluorescence-guided laparoscopic hepatectomy (FGLH) and 60 cases of traditional laparoscopic hepatectomy (LH), was conducted. R0 resection rate, operation time, intraoperative blood loss, complications, hospital stay, and other intraoperative and postoperative indicators of the two groups were analyzed to determine the clinical feasibility and safety of ICG fluorescence real-time imaging-guided technology in laparoscopic hepatectomy. Related databases were searched for retrospective cohort studies and randomized controlled trials comparing FGLH with LH, studies were screened according to preset inclusion and exclusion criteria, literature quality was evaluated, and data were extracted. RevMan 5.3 software was used to conduct a meta-analysis on the extracted data. The results of our clinical data and meta-analysis showed that compared with LH, FGLH increased the R0 resection rate, shortened the operation time and postoperative hospital stay, and reduced blood loss and the occurrence of postoperative complications. Compared with LH, FGLH has a better application effect in laparoscopic hepatectomy, and it is worthy of promotion as it is safe and feasible.

Keywords: fluorescence imaging; hepatocellular carcinoma (HCC); indocyanine green; laparoscopic hepatectomy; meta-analysis.

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Copyright © 2022 Chen, Wang, Xie, Zhang, Ge, Yu, Zhang, Jia, Ma and Liu.

Figures

Figure 1
Figure 1
Positive staining. Liver resection under ICG navigation step by step.
Figure 2
Figure 2
Literature screening flowchart.
Figure 3
Figure 3
R0 resection between groups with and without ICG fluorescence navigation.
Figure 4
Figure 4
Operation time.
Figure 5
Figure 5
Perioperative bleeding volume.
Figure 6
Figure 6
Postoperative hospital stay.
Figure 7
Figure 7
Comparison of postoperative complications.
Figure 8
Figure 8
Evaluating publication bias by a funnel chart. (A) R0 resection; (B) operation time; (C) intraoperative blood loss; (D) postoperative hospital stay; (E) postoperative complications.
Figure 9
Figure 9
Sankey diagram showing the statistical differences between the two groups.

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