Safety And Feasibility Analysis Of Laparoscopic Anatomical Right Hepatectomy Guided By ICG Fluorescence Fusion Technique In The Treatment Of Liver Neoplasms

Objective: To explore the safety and feasibility of laparoscopic anatomical right hepatectomy guided by ICG fluorescence fusion technique in the treatment of liver neoplasms.Methods: A retrospective cross-sectional study was conducted to enroll108 patients with hepatic malignancies admitted to the Department of Hepatobiliary Surgery in Hunan Provincial People’s Hospital from January 2016 to December 2018.The clinical data of the patients were collected.The patient’s residual liver volume was calculated before operation,and a liver function reserve test was performed to evaluate the patient’s tolerance to laparoscopic right hepatectomy.According to whether ICG fusion technique was performed during intraoperative laparoscopic surgery,all patients were divided into two groups,fluorescent laparoscopic anatomical right hepatic group(experimental group)and non-fluorescent laparoscopic anatomical right hepatectomy group(control group).Intraoperative and postoperative clinical data of patients in both groups were compared and analyzed.Results: There were 108 patients undergoing laparoscopic anatomical right hepatectomy.Among them,24 patients were enrolled in the experimental group and another 84 patients were enrolled in the control group.In the experimental group,there were 3 patients failing to stain.One of them failed for forward staining method and another two failed for reverse staining method.Intraoperatively,compared with the control group,the operation time of the experimental group(274.58±42.12 min vs 303.99±54.67 min,P<0.05)and hepatic occlusion time(52.71±9.09 min vs 59.58±11.56 min,P<0.05)was shorter,which were statistically significant;intraoperative blood loss(305.42 ± 74.07 ml vs 317.86 ±165.49 ml,P > 0.05)has no significant difference between two groups.Postoperatively,there was no significant difference in hospitalization time,tumor diameter,lung infection,hemorrhage and bile leakage between two groups(P>0.05).Conclusion: ICG fluorescence imaging laparoscopic anatomical right hepatectomy is helpful for the confirmation of intraoperative hepatic plane,thus reducing the operation time and hepatic occlusion time.Meanwhile,it can be used for the detection of intraoperative bile leakage.The development of ICG fluorescence fusion technology is conducive to the promotion of laparoscopic anatomical right hepatectomy.With strict control of indications,ICG fluorescence fusion technology can effectively improve the controllability and safety of laparoscopic anatomical right hepatectomy.