Clinical application of indocyanine green fluorescence fusion imaging in anatomical hepatectomy

Abstract

Objective To study the clinical application of indocyanine green fluorescence fusion imaging (FIGFI) in anatomical hepatectomy. Methods The clinical data of 41 patients who underwent anatomical hepatectomy with guidance of FIGFI from March to June 2017 in our department were analyzed retrospectively. The data included: (1) Intraoperative data: surgical procedure, extent of hepatectomy, ICG fluorescent staining procedure and result, operation time, intraoperative blood loss and intraoperative blood transfusion. (2) Postoperative data: postoperative complications and pathology. Results Of the 35 patients who underwent laparoscopic anatomical hepatectomy, 34 patients were successfully carried out under FIGFI guidance. One patient was converted to laparotomy. For the 6 patients who underwent laparotomy, liver resections were successfully carried out. Of all the 41 patients, 37 had successful staining but 4 failed. Staining failure mostly occurred in patients who underwent anti-staining in liver segments with multiple vascular branching supply because not all the target liver pedicles were blocked before injecting ICG. Conclusions FIGFI guided anatomical hepatectomy is a very promising technique. The combination of preoperative imagings, intraoperative laparoscopic ultrasound guidance and FIGFI helped to achieve the goal of anatomical liver resection. Key words: Anatomical hepatectomy; Indocyanine green; Fluorescence imaging; Laparoscopy