To evaluate the application value of ICG fluorescence imaging in precise laparoscopic hepatectomy.

Clinical data of 16 patients who underwent ICG fluorescence-guided precise laparoscopic hepatectomy in the First Affiliated Hospital of China University of Science and Technology from May 2020 to February 2022 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. Among them, 13 patients were male and 3 female, aged from 35 to 67 years, with a median age of 57 years. 15 patients were diagnosed with hepatocellular carcinoma and 1 case with focal nodular hyperplasia of the liver. All patients were classified as Child-Pugh grade A before surgery. According to the tumor location, different ICG staining methods were adopted including ICG tumor staining, positive staining and negative staining. Intraoperative ICG staining and perioperative conditions were observed.

15 patients underwent ICG fluorescence-guided precise laparoscopic hepatectomy successfully, while the staining of 1 case failed. No conversion to open surgery was conducted. Among them, resection of caudate lobe segment 1 were performed in 2 cases and ICG tumor staining was employed. Resection of segment 2 was performed in 1 case, and segment 3 in 2 cases, and positive staining was adopted. Segment 4 resection was conducted in 2 and segment 5 in 1 case, and negative staining was carried out. Segment 6 resection was performed in 4 cases, segment 7 in 1 case and segment 8 in 3 cases, and positive staining was adopted. The median operation time was 245(226-278) min, the hepatic portal occlusion time was 30(20-30) min, intraoperative blood loss was 200(100-300) ml, intraoperative blood transfusion was performed in 2 cases, and the length of postoperative hospital stay was 6(5-8) d. No death case was observed within postoperative 90 d. No Clavien-Dindo gradeⅡ or above complications were reported.

ICG fluorescence can deliver real-time and highly-efficient guidance for the entire process of laparoscopic hepatectomy, which possesses the advantages of precision, minimal invasiveness and safety.