Application of indocyanine green fluorescence imaging in anatomical hepatectomy for hepatocellular carcinoma

doi:10.3877/cma.j.issn.2095-3232.2019.03.010

Abstract

Abstract:

Objective

To investigate the application value of indocyanine green (ICG) fluorescence imaging in anatomical hepatectomy for hepatocellular carcinoma (HCC).

Methods

55 patients with HCC who underwent anatomical hepatectomy in the First Affiliated Hospital of University of Science and Technology of China from June 2017 to July 2018 were enrolled in this prospective study. The informed consents of all patients were obtained and the local ethical committee approval was received. According to the random number table method, all patients were randomly divided into ICG group (n=28) and control group (n=27). In ICG group, 23 patients were male and 5 female, aged (54±12) years on average. Anatomical hepatectomy was performed using ICG fluorescence imaging. In control group, 22 patients were male and 5 female, aged (58±12) years on average. Conventional anatomical hepatectomy was performed. The surgery-related parameters were statistically compared between two groups by using t test or Chi-square test.

Results

In ICG group, the operation time was (245±62) min, significantly longer than (198±60) min in control group (t=2.857, P<0.05). In ICG group, the percentage of intraoperative blood transfusion was 7% (2/28), significantly lower than 45% (12/22) in control group (χ²=10.079, P<0.05). In ICG group, the drainage extubation time was (6.3±2.4) d and the highest body temperature was (37.7±0.4)℃ respectively, significantly less than (8.4±4.4) d and (38.0±0.6)℃ in control group (t=-2.194, -2.179; P<0.05).

Conclusions

ICG fluorescence imaging can clearly define the range of liver resection and accelerate the postoperative rehabilitation of patients, which can serve as an auxiliary approach for anatomical hepatectomy.

Key words: Carcinoma, hepatocellular, Indocyanine green, Fluorescence, Hepatectomy

Shunyu Yao, Weidong Jia, Yongsheng Ge, Geliang Xu, Jinliang Ma. Application of indocyanine green fluorescence imaging in anatomical hepatectomy for hepatocellular carcinoma[J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2019, 08(03): 221-225.

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References 25

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临床参数	ICG示踪组	对照组	统计值	P值
男/女	23/5	22/5	χ² =0.000	>0.05
年龄（岁，±s ）	54±12	58±12	t=-1.361	>0.05
肿瘤直径（cm，±s ）	6±3	8±4	t=-1.988	>0.05
HBsAg阳性（例）	21	22	χ² =0.339	>0.05
HBV-DNA定量> 1 000 copies/ml（例）	13	12	χ² =0.022	>0.05
肝硬化（例）	20	21	χ² =0.292	>0.05
AFP阳性（例）	23	25	χ² =0.574	>0.05
肝切除史（例）	2	1	χ² =0.000	>0.05

临床参数	ICG示踪组	对照组	统计值	P值
男/女	23/5	22/5	χ² =0.000	>0.05
年龄（岁，±s ）	54±12	58±12	t=-1.361	>0.05
肿瘤直径（cm，±s ）	6±3	8±4	t=-1.988	>0.05
HBsAg阳性（例）	21	22	χ² =0.339	>0.05
HBV-DNA定量> 1 000 copies/ml（例）	13	12	χ² =0.022	>0.05
肝硬化（例）	20	21	χ² =0.292	>0.05
AFP阳性（例）	23	25	χ² =0.574	>0.05
肝切除史（例）	2	1	χ² =0.000	>0.05

组别	例数	手术时间（min）	术后住院时间（d）	引流管拔管时间（d）
ICG示踪组	28	245±62	10±6	6.3±2.4
对照组	27	198±60	12±5	8.4±4.4
t值	?	2.857	-1.357	-2.194
P值	?	0.006	0.180	0.034

组别	例数	手术时间（min）	术后住院时间（d）	引流管拔管时间（d）
ICG示踪组	28	245±62	10±6	6.3±2.4
对照组	27	198±60	12±5	8.4±4.4
t值	?	2.857	-1.357	-2.194
P值	?	0.006	0.180	0.034

组别	例数	出血	胆漏	腹腔积液	胸腔积液	并发症Clavien分级≥Ⅱ级
ICG示踪组	28	0	0	12	8	8
对照组	27	4	1	14	13	10
χ²值	?	-	-	0.446	2.232	0.447
P值	?	0.111	0.491	0.504	0.135	0.504

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