探讨ICG荧光显像技术在原发性肝癌（肝癌）腹腔镜肝切除术（LH）中应用的安全性及疗效。

回顾性分析2018年1月至2021年12月在中国科学技术大学附属第一医院行LH的121例肝癌患者临床资料。患者均签署知情同意书，符合医学伦理学规定。其中男98例，女23例；年龄19~85岁，中位年龄56岁。根据手术方式不同将患者分为ICG荧光显像腹腔镜肝切除术（FGLH）组（52例）和LH组（69例）。比较两组围手术期情况及生存情况。两组手术时间比较采用t检验，第一肝门阻断时间、术中出血量比较采用秩和检验，术后并发症发生率比较采用χ²检验。生存分析采用Kaplan-Meier法和Log-rank检验。

FGLH组平均手术时间为（238±72）min，明显低于LH组的（291±117）min（t=-2.868，P<0.05）。FGLH组第一肝门阻断时间、术中出血量中位数分别为22（30）min、200（200）ml，明显少于FH组的25（25）min、200（300）ml（Z=-1.997，-2.067；P<0.05）。FGLH组术后并发症发生率为10%（5/52），明显低于LH组的25%（17/69） （χ²=4.498，P<0.05）。两组术后均未发生严重并发症，均无围手术期死亡。FGLH组和LH组中位生存期分别为50.3、39.4个月，两组累积生存率比较差异无统计学意义（χ²=3.196，P>0.05）。

ICG荧光显像技术在LH中应用安全、有效，具有手术时间短、术中出血量少、术后并发症发生率低的优势。

To evaluate the safety and efficacy of indocyanine green (ICG) fluorescence imaging in laparoscopic hepatectomy (LH) for primary liver cancer (PLC).

Clinical data of 121 patients with PLC who underwent LH in the First Affiliated Hospital of University of Science and Technology of China from January 2018 to December 2021 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. Among them, 98 patients were male and 23 female, aged from 19 to 85 years, with a median age of 56 years. According to different surgical approaches, all patients were divided into the ICG fluorescence imaging LH (FGLH) group (n=52) and LH group (n=69). Perioperative conditions and survival were compared betweentwo groups. The operation time between two groups was compared by t test. The occlusion time of porta hepatis and intraoperative blood loss were analyzed by rank-sum test. The incidence of postoperative complications was assessed by Chi-square test. Survival analysis was conducted by Kaplan-Meier method and Log-rank test.

The average operation time in the FGLH group was (238±72) min, significantly shorter than (291±117) min in the LH group (t=-2.868, P<0.05). In the FGLH group, the median occlusion time of porta hepatis and intraoperative blood loss were 22(30) min and 200(200) ml, significantly less than 25(25) min and 200(300) ml in the FH group (Z=-1.997, -2.067; P<0.05). The incidence of postoperative complications in the FGLH group was 10%(5/52), significantly lower than 25%(17/69) in the LH group (χ²=4.498, P<0.05). No severe postoperative complications or perioperative death occurred in two groups. The median survival time in the FGLH and LH groups was 50.3 and 39.4 months. No significant difference was noted in the cumulative survival rate between two groups (χ²=3.196, P>0.05).

It is safe and effective to adopt ICG fluorescence imaging in LH, which requires short operation time, yields slight intraoperative blood loss and low incidence of postoperative complications.