PT  - JOURNAL ARTICLE
AU  - TOMIOKA, KODAI
AU  - AOKI, TAKESHI
AU  - TASHIRO, YOSHIHIKO
AU  - KUSANO, TOMOKAZU
AU  - MATSUDA, KAZUHIRO
AU  - YAMADA, KOSUKE
AU  - NOGAKI, KOJI
AU  - WADA, YUSUKE
AU  - SHIBATA, HIDEKI
AU  - HIRAI, TAKAHITO
AU  - YAMAZAKI, TATSUYA
AU  - SAITO, KAZUHIKO
AU  - UCHIDA, MARIE
AU  - NAGAISHI, SHODAI
AU  - FUJIMORI, AKIRA
AU  - ENAMI, YUTA
TI  - Laparoscopic Anatomical Liver Resection Using Liver Mapping of Incidental Indocyanine Green Fluorescence due to Cholestasis
AID  - 10.21873/anticanres.16760
DP  - 2023 Dec 01
TA  - Anticancer Research
PG  - 5583--5588
VI  - 43
IP  - 12
4099  - http://ar.iiarjournals.org/content/43/12/5583.short
4100  - http://ar.iiarjournals.org/content/43/12/5583.full
SO  - Anticancer Res2023 Dec 01; 43
AB  - Background/Aim: Indocyanine green (ICG) fluorescence is useful in laparoscopic hepatectomy (LH) for tumor identification and staining, as well as determination of resection margins. At our Institution, patient-specific, three-dimensional simulations and rehearsal of surgical strategies are carried out preoperatively. We describe cases in which ICG administered preoperatively became stagnated and fluoresced in an area similar to the preoperatively established resection area and the pathological findings in these cases. Patients and Methods: Four patients who underwent LH at our hospital between 2020 and 2023 (due to hepatocellular carcinoma in two and colorectal liver metastasis in two) were enrolled in the present study. The ICG-fluorescing liver segments were resected laparoscopically and their pathological characteristics were examined using a fluorescence microscope. Results: In four cases, the areas of ICG fluorescence seen intraoperatively were due to stasis of preoperatively administered ICG, which fortuitously was equivalent to the planned resection area in the preoperative patient-specific simulation. The fluorescent areas were resected; there were no cases of bile leakage or recurrence. Fluorescence microscopy revealed areas with diffuse ICG fluorescence in normal hepatocytes on the tumor’s peripheral side. Conclusion: It was suggested that resection of the liver area that was fluorescent due to stagnation of preoperatively administered ICG was rational and justified both anatomically and oncologically. This resection may also contribute to the prevention of bile leakage and recurrence.