Application Of Indocyanine Green Fluorescence In Hepatectomy Of Complex Segment Hepatocellular Carcinoma

Objective: To investigate the application of indocyanine green fluorescence in hepatic resection of complex hepatic segmental hepatocellular carcinoma,and to propose a feasible solution for complex hepatic segmental hepatocellular carcinoma in the treatment.Methods: The data of a total of 42 patients with laparoscopic hepatectomy(Laparoscopy Hepatectomy,LH)with preoperative or postoperative pathologically confirmed hepatocellular carcinoma from July 2019 to July 2021 in the Department of Hepatobiliary Surgery,Guizhou Provincial People’s Hospital were retrospectively analyzed.They were divided into two groups: the indocyanine green-injected group(n=21)underwent fluoroscopic laparoscopic hepatectomy;the non-indocyanine green-injected group(n=21)underwent conventional laparoscopic hepatectomy.We compared the operative time,intraoperative bleeding,intraoperative blood transfusion,postoperative admission to ICU,positive incision margin,postoperative hospitalization time,intermediate open abdomen,major postoperative complications,postoperative extubation time,postoperative alanine aminotransferase(ALT)on days 3 and 6,postoperative total bilirubin(TB)on days 3 and 6. bilirubin(TBil),direct bilirubin(DBil),indirect bilirubin(IBil),albumin(ALB).Results: Comparing the data of the two groups,there were statistically significant differences between the indocyanine green-injected group and the non-indocyanine greeninjected group in terms of operative time,intraoperative bleeding,intraoperative blood transfusion,intermediate opening,postoperative discharge time,postoperative day 3 total bilirubin,postoperative day 6 direct bilirubin,postoperative day 6 albumin(P < 0.05;)in terms of positive incisional margin,postoperative extubation time,major postoperative complications,postoperative day day 3 ALT,postoperative day 3 indirect bilirubin,postoperative day 3 albumin,postoperative day 6 ALT,postoperative day 6 total bilirubin,postoperative day 6 direct bilirubin,postoperative day 6 indirect bilirubin,the results were not significantly different and not statistically significant.Conclu For complex hepatic segmental hepatocellular carcinoma,fluoroscopic laparoscopic hepatectomy provides less operative time and intraoperative bleeding compared with conventional laparoscopic hepatectomy,provides real-time and reliable basis for intraoperative tumor localization,boundary determination,and optimizes the surgical plan.