Clinical Effects of the Use of the Indocyanine Green Fluorescence Imaging Technique in Laparoscopic Partial Liver Resection

Overview

Journal Ann Gastroenterol Surg

Date 2022 Sep 12

PMID 36091307

Authors

Shinji Itoh

Takahiro Tomiyama

Akinari Morinaga

Takeshi Kurihara

Yoshihiro Nagao

Takeo Toshima

Kazutoyo Morita

Noboru Harada

Masaki Mori

Tomoharu Yoshizumi

Affiliations

Soon will be listed here.

Abstract

Aim: This study aimed to clarify the clinical effects of the indocyanine green (ICG)-fluorescence imaging (FI) technique for determination of liver transection lines during laparoscopic partial liver resection for liver tumors.

Methods: This was a retrospective study including 112 patients who underwent laparoscopic partial liver resection for liver tumors. These enrolled patients were divided into an ICG-FI group (n = 55) and a non-ICG-FI group (n = 57) according to the availability of the ICG-FI. The clinicopathological characteristics of patients between two groups were compared before and after propensity score matching.

Results: The ICG-FI and non-ICG-FI groups differed at baseline in terms of ICG retention rate at 15 min. After propensity score matching, two comparable groups of 32 patients each were obtained. The negativity rated of the pathological surgical margins were comparable between the two groups before and after propensity score matching. However, the surgical margins were significantly wider in the ICG-FI group before and after propensity score matching ( = .039 and = .047, respectively).

Conclusion: The ICG-fluorescence imaging technique may offer clinical benefits in terms of a secure surgical margin in laparoscopic partial liver resection.

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References

Aoki T, Murakami M, Koizumi T, Matsuda K, Fujimori A, Kusano T . Determination of the surgical margin in laparoscopic liver resections using infrared indocyanine green fluorescence. Langenbecks Arch Surg. 2018; 403(5):671-680. DOI: 10.1007/s00423-018-1685-y. View

Kokudo N, Takemura N, Ito K, Mihara F . The history of liver surgery: Achievements over the past 50 years. Ann Gastroenterol Surg. 2020; 4(2):109-117. PMC: 7105847. DOI: 10.1002/ags3.12322. View

Aoki T, Kubota K, Hasegawa K, Kubo S, Izumi N, Kokudo N . Significance of the surgical hepatic resection margin in patients with a single hepatocellular carcinoma. Br J Surg. 2019; 107(1):113-120. DOI: 10.1002/bjs.11329. View

Terasawa M, Ishizawa T, Mise Y, Inoue Y, Ito H, Takahashi Y . Applications of fusion-fluorescence imaging using indocyanine green in laparoscopic hepatectomy. Surg Endosc. 2017; 31(12):5111-5118. DOI: 10.1007/s00464-017-5576-z. View

Lu H, Gu J, Qian X, Dai X . Indocyanine green fluorescence navigation in laparoscopic hepatectomy: a retrospective single-center study of 120 cases. Surg Today. 2020; 51(5):695-702. PMC: 8055570. DOI: 10.1007/s00595-020-02163-8. View

Tsilimigras D, Sahara K, Moris D, Hyer J, Paredes A, Bagante F . Effect of Surgical Margin Width on Patterns of Recurrence among Patients Undergoing R0 Hepatectomy for T1 Hepatocellular Carcinoma: An International Multi-Institutional Analysis. J Gastrointest Surg. 2019; 24(7):1552-1560. DOI: 10.1007/s11605-019-04275-0. View

Sadot E, Groot Koerkamp B, Leal J, Shia J, Gonen M, Allen P . Resection margin and survival in 2368 patients undergoing hepatic resection for metastatic colorectal cancer: surgical technique or biologic surrogate?. Ann Surg. 2015; 262(3):476-85. PMC: 4533113. DOI: 10.1097/SLA.0000000000001427. View

Clavien P, Barkun J, De Oliveira M, Vauthey J, Dindo D, Schulick R . The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg. 2009; 250(2):187-96. DOI: 10.1097/SLA.0b013e3181b13ca2. View

Wu L, Tsilimigras D, Paredes A, Mehta R, Hyer J, Merath K . Trends in the Incidence, Treatment and Outcomes of Patients with Intrahepatic Cholangiocarcinoma in the USA: Facility Type is Associated with Margin Status, Use of Lymphadenectomy and Overall Survival. World J Surg. 2019; 43(7):1777-1787. DOI: 10.1007/s00268-019-04966-4. View

10.

Nakashima Y, Saeki H, Yukaya T, Tsutsumi S, Nakanishi R, Sugiyama M . Blood Flow Assessment with Indocyanine Green Fluorescence Angiography for Pedicled Omental Flap on Cervical Esophagogastric Anastomosis after Esophagectomy. J Am Coll Surg. 2016; 222(5):e67-9. DOI: 10.1016/j.jamcollsurg.2016.01.048. View

11.

Ciria R, Cherqui D, Geller D, Briceno J, Wakabayashi G . Comparative Short-term Benefits of Laparoscopic Liver Resection: 9000 Cases and Climbing. Ann Surg. 2015; 263(4):761-77. DOI: 10.1097/SLA.0000000000001413. View

12.

Achterberg F, Sibinga Mulder B, Meijer R, Bonsing B, Hartgrink H, Mieog J . Real-time surgical margin assessment using ICG-fluorescence during laparoscopic and robot-assisted resections of colorectal liver metastases. Ann Transl Med. 2020; 8(21):1448. PMC: 7723628. DOI: 10.21037/atm-20-1999. View

13.

Watanabe Y, Matsuyama Y, Izumi N, Kubo S, Kokudo N, Sakamoto M . Effect of surgical margin width after R0 resection for intrahepatic cholangiocarcinoma: A nationwide survey of the Liver Cancer Study Group of Japan. Surgery. 2020; 167(5):793-802. DOI: 10.1016/j.surg.2019.12.009. View

14.

Ishizawa T, Saiura A, Kokudo N . Clinical application of indocyanine green-fluorescence imaging during hepatectomy. Hepatobiliary Surg Nutr. 2016; 5(4):322-8. PMC: 4960410. DOI: 10.21037/hbsn.2015.10.01. View

15.

Itoh S, Tomiyama T, Morinaga A, Kurihara T, Nagao Y, Toshima T . Clinical effects of the use of the indocyanine green fluorescence imaging technique in laparoscopic partial liver resection. Ann Gastroenterol Surg. 2022; 6(5):688-694. PMC: 9444859. DOI: 10.1002/ags3.12563. View

16.

Yoshiya S, Minagawa R, Kamo K, Kasai M, Taketani K, Yukaya T . Usability of Intraoperative Fluorescence Imaging with Indocyanine Green During Laparoscopic Cholecystectomy After Percutaneous Transhepatic Gallbladder Drainage. World J Surg. 2018; 43(1):127-133. DOI: 10.1007/s00268-018-4760-1. View

17.

Alfano M, Molfino S, Benedicenti S, Molteni B, Porsio P, Arici E . Intraoperative ICG-based imaging of liver neoplasms: a simple yet powerful tool. Preliminary results. Surg Endosc. 2018; 33(1):126-134. DOI: 10.1007/s00464-018-6282-1. View

18.

Wishart G, Loh S, Jones L, Benson J . A feasibility study (ICG-10) of indocyanine green (ICG) fluorescence mapping for sentinel lymph node detection in early breast cancer. Eur J Surg Oncol. 2012; 38(8):651-6. DOI: 10.1016/j.ejso.2012.05.007. View

19.

Kurihara T, Yamashita Y, Yoshida Y, Takeishi K, Itoh S, Harimoto N . Indocyanine Green Fluorescent Imaging for Hepatic Resection of the Right Hepatic Vein Drainage Area. J Am Coll Surg. 2015; 221(3):e49-53. DOI: 10.1016/j.jamcollsurg.2015.05.009. View