J Cancer 2020; 11(9):2465-2475. doi:10.7150/jca.41039

Research Paper

Precise right hemihepatectomy for the treatment of hepatocellular carcinoma guided by fusion ICG fluorescence imaging

Shunyu Yao1,2*, Luyuan Zhang3*, Jinliang Ma1, Weidong Jia1,2, Hao Chen1,2✉

1. Department of Hepatic Surgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, HeFei, 230001, China
2. Anhui Province Key Laboratory of Hepatopancreatobiliary Surgery, HeFei, 230001, China
3. Xiangya School of Medicine, Central South University, ChangSha, 410008, China
* These authors contributed equally to this work.

This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/). See http://ivyspring.com/terms for full terms and conditions.
Citation:
Yao S, Zhang L, Ma J, Jia W, Chen H. Precise right hemihepatectomy for the treatment of hepatocellular carcinoma guided by fusion ICG fluorescence imaging. J Cancer 2020; 11(9):2465-2475. doi:10.7150/jca.41039. Available from http://www.jcancer.org/v11p2465.htm

File import instruction

Abstract

To evaluate the clinical significance of fusion indocyanine green (ICG) fluorescence imaging in precise right hemihepatectomy for the treatment of hepatocellular carcinoma (HCC). 47 patients with HCC who underwent right hemihepatectomy were retrospectively analyzed. 18 of them guided by fusion ICG fluorescence imaging (FIGFI) while 29 patients underwent conventional right hepatectomy without guidance. Compared to the patients with conventional treatment, the intraoperative blood loss of the patients with guided surgery was significantly less, and no transfusion and hepatic occlusion were performed during the operation. Liver function recovery faster in guided group. The incidence of postoperative complications is also lower, and the recurrence rate in one year is significantly reduced. ICG fluorescence range of 18 patients in liver surface was consistent with the ischemic line, and their postoperative liver cross-sections were clearly demarcation. There were no significant differences in the mean operation time, blood loss, postoperative hospital stays, cases of blood transfusion, complication rate, or postoperative peak volume of ALT and TB between positive or negative staining groups. Pathology results of all patients demonstrated HCC and negative margins, and microvascular invasion occurred in 8 cases. The average follow-up time of 18 patients was 16.7 months, and recurrence was found in 5 cases after surgery. FIGFI could guide the anatomical right hepatectomy with real -time increased radical rate, accuracy and safety for the treatment of HCC, and therefore showed a promising prospect.

Keywords: Indocyanine, Green fluorescence imaging, Hepatocellular carcinoma, Precise, Hemihepatectomy