Application value of indocyanine green injection via percutaneous transhepatic portal vein puncture under ultrasound guidance during laparoscopic anatomical liver resection
10.3760/cma.j.cn115610-20241120-00500
- VernacularTitle:超声引导下经皮经肝门静脉穿刺注射吲哚菁绿在腹腔镜解剖性肝切除术中的应用价值
- Author:
Zisen LAI
1
;
Jiahui LYU
1
;
Guangwen LIU
1
;
Qian LIN
1
;
Jiacheng ZHANG
1
;
Liming HUANG
1
;
Yongyi ZENG
1
Author Information
1. 福建医科大学孟超肝胆医院肝胆外科，福州 350028
- Publication Type:Journal Article
- Keywords:
Liver neoplasms;
Anatomical liver resection;
Fluorescence imaging;
Indo-cyanine green;
Liver plane interruption;
Surgery;
Efficacy;
Laparoscopy
- From:
Chinese Journal of Digestive Surgery
2024;23(12):1544-1549
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the application value of indocyanine green (ICG) injection via percutaneous transhepatic portal vein under ultrasound guidance during laparoscopic anatomical liver resection.Methods:The retrospective and descriptive study was conducted. The clinicopatho-logical data of 17 male patients with hepatocellular carcinoma who underwent laparoscopic anatomical liver resection in Mengchao Hepatobiliary Hospital of Fujian Medical University from October 2022 to May 2024 were collected. The patients were aged 59(range, 27-74)years. Patients underwent ICG fluorescence-guided laparoscopic anatomical liver resection after ICG injection via percutaneous transhepatic portal vein under ultrasound guidance. Obsevation indicators: (1)surgical situations; (2) postoperative situations; (3) follow-up. Measurement data with normal distribution were represented as Mean± SD. Measurement data with skewed distribution were represented as M(range). Count data were represented as absolute numbers. Results:(1) Surgical situations. All 17 patients were successfully punctured and injected with ICG via percutaneous transhepatic portal vein under ultrasound guidance, with a puncture time of 6(range,3-12)minutes. The fluorescence staining successfully displayed at the target liver segment without infiltration, and the distance from the fluorescence staining border to the tumor edge was greater than 1.0 cm, which was consistent with preoperative three-dimensional reconstruction imaging. Among the 17 patients, 11 cases had punctures in one branch of the portal vein, 4 cases had punctures in two branches, and 2 had punctures in three branches. The operation time was (229±51)minutes, volume of intraoperative blood loss was 200(range, 100-300)mL. No blood transfusion or conversion to open surgery was required during the operation. (2) Postoperative situations. Two of 17 patients had a small pleural effusion of grade Ⅰ-Ⅱ of Clavien-Dindo classification, and were recovered without treatment. The duration of postoperative hospital stay was 5(range, 5-6)days. Postoperative pathological examina-tion showed hepatocellular carcinoma with negative surgical margin. The tumor diameter was 4.5(range, 1.8-12.5)cm. (3) Follow-up. All the 17 patients were followed up for 14(range, 2-30)months, without tumor recurrence.Conclusion:Injection of ICG via percutaneous transhepatic portal vein under ultrasound guidance during laparoscopic anatomical liver resection is safe and feasible.
