RT Journal Article
SR Electronic
T1 Laparoscopic Anatomical Liver Resection Using Liver Mapping of Incidental Indocyanine Green Fluorescence due to Cholestasis
JF Anticancer Research
JO Anticancer Res
FD International Institute of Anticancer Research
SP 5583
OP 5588
DO 10.21873/anticanres.16760
VO 43
IS 12
A1 TOMIOKA, KODAI
A1 AOKI, TAKESHI
A1 TASHIRO, YOSHIHIKO
A1 KUSANO, TOMOKAZU
A1 MATSUDA, KAZUHIRO
A1 YAMADA, KOSUKE
A1 NOGAKI, KOJI
A1 WADA, YUSUKE
A1 SHIBATA, HIDEKI
A1 HIRAI, TAKAHITO
A1 YAMAZAKI, TATSUYA
A1 SAITO, KAZUHIKO
A1 UCHIDA, MARIE
A1 NAGAISHI, SHODAI
A1 FUJIMORI, AKIRA
A1 ENAMI, YUTA
YR 2023
UL http://ar.iiarjournals.org/content/43/12/5583.abstract
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.