Abstract:

Objective

To evaluate the application value of three-dimensional visualization combined with ICG imaging in laparoscopic hepatectomy for recurrent hepatocellular carcinoma （HCC）.

Methods

Clinical data of 5 patients with recurrent HCC who underwent surgery in Baoji People's Hospital from January 2022 to June 2023 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. Among them，2 patients were male and 3 female，aged 49-78 years，with a median age of 66 years. Preoperatively，three-dimensional visualized liver reconstruction was performed by computer-aided surgical system，and combined with intraoperative ICG fluorescence imaging for laparoscopic hepatectomy. The safety and feasibility of this technology in the treatment of recurrent HCC were evaluated.

Results

All 5 patients successfully completed laparoscopic hepatectomy without conversion to open surgery. The average operation time was （274±18） min，and intraoperative blood loss was （390±85） ml. 1 patient developed postoperative bile leakage and was cured after adequate drainage. No bleeding，abdominal infection or liver failure occurred after operation. Surgical margin of the liver was negative. The length of postoperative hospital stay was （9.2±1.9） d. All 5 patients were followed up for 6-24 months，and there was no tumor recurrence during postoperative follow-up. No patient died within postoperative 90 d.

Conclusions

Three-dimensional visualization combined with ICG fluorescence imaging technology is safe and feasible for patients with recurrent HCC undergoing laparoscopic hepatectomy. Intraoperatively，it can precisely locate the tumor and has potential advantages of mild trauma and slight bleeding.

Key words: Carcinoma，hepatocellular, Recurrence, Laparoscopes, Hepatectomy, Indocyanine green, Fluorescence imaging, Imaging，three-dimensional