Laparoscopic Glissonean pedicle transection anatomic hepatectomy using indocyanine green fluorescence imaging technology_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

ZHANG Pengliang ,  HUANG Jiwei , ZENG Yong , WU Hong

Department of Liver Surgery, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;

Corresponding author：

HUANG Jiwei, Email: huangjiweimd@hotmail.com

Keywords：

Indocyanine green fluorescence imaging; laparoscopic hepatectomy; anatomic hepatectomy

DOI：

10.7507/1007-9424.201809064

Video：

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Objective To evaluate efficacy and safety of laparoscopic Glissonean pedicle transection anatomic hepatectomy using indocyanine green (ICG) fluorescence imaging.Method The retrospective analysis was made on the preoperative clinical data, surgical treatment and postoperative status of a patient with hepatocellular carcinoma who underwent the laparoscopic Glissonean pedicle transection anatomic hepatectomy using the ICG fluorescence imaging technology in the Department of Liver Surgery, West China Hospital of Sichuan University.Results According to the preoperative history, imaging and laboratory examinations, the diagnosis of hepatocellular carcinoma was considered. The intraoperative exploration revealed that there was only one tumor located in the segment Ⅳ and was superficial. The ICG fluorescence imaging was used to perform the Glissonean pedicle transection anatomic hepatectomy. The postoperative pathological diagnosis was consistent with hepatocellular carcinoma without serious complications. The patient recovered well. No recurrence was found in the follow-up period up to 6 months.Conclusions Laparoscopic Glissonean pedicle transection anatomic hepatectomy using ICG fluorescence technology can be used as a safe and precise treatment to solve problems such as bleeding during operation, difficult determination of tumor boundary, and whether having residual tumor in surgical margin.

Citation： ZHANG Pengliang, HUANG Jiwei, ZENG Yong, WU Hong. Laparoscopic Glissonean pedicle transection anatomic hepatectomy using indocyanine green fluorescence imaging technology. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2019, 26(5): 584-588. doi: 10.7507/1007-9424.201809064 Copy

1.	Reich H, McGlynn F, DeCaprio J, et al. Laparoscopic excision of benign liver lesions. Obstet Gynecol, 1991, 78(5 Pt 2): 956-958.
2.	Takasaki K. Glissonean pedicle transection method for hepatic resection: a new concept of liver segmentation. J Hepatobiliary Pancreat Surg, 1998, 5(3): 286-291.
3.	Topal B, Aerts R, Penninckx F. Laparoscopic intrahepatic Glissonian approach for right hepatectomy is safe, simple, and reproducible. Surg Endosc, 2007, 21(11): 2111.
4.	Cho A, Asano T, Yamamoto H, et al. Laparoscopy-assisted hepatic lobectomy using hilar Glissonean pedicle transection. Surg Endosc, 2007, 21(8): 1466-1468.
5.	Ikeda T, Yonemura Y, Ueda N, et al. Pure laparoscopic right hepatectomy in the semi-prone position using the intrahepatic Glissonian approach and a modified hanging maneuver to minimize intraoperative bleeding. Surg Today, 2011, 41(12): 1592-1598.
6.	Machado MA, Surjan RC, Makdissi FF. Video: intrahepatic Glissonian approach for pure laparoscopic right hemihepatectomy. Surg Endosc, 2011, 25(12): 3930-3933.
7.	Machado MA, Kalil AN. Glissonian approach for laparoscopic mesohepatectomy. Surg Endosc, 2011, 25(6): 2020-2022.
8.	Landsman ML, Kwant G, Mook GA, et al. Light-absorbing properties, stability, and spectral stabilization of indocyanine green. J Appl Physiol, 1976, 40(4): 575-583.
9.	Abo T, Nanashima A, Tobinaga S, et al. Usefulness of intraoperative diagnosis of hepatic tumors located at the liver surface and hepatic segmental visualization using indocyanine green-photodynamic eye imaging. Eur J Surg Oncol, 2015, 41(2): 257-264.
10.	Ishizawa T, Fukushima N, Shibahara J, et al. Real-time identification of liver cancers by using indocyanine green fluorescent imaging. Cancer, 2009, 115(11): 2491-2504.
11.	Lim C, Vibert E, Azoulay D, et al. Indocyanine green fluorescence imaging in the surgical management of liver cancers: current facts and future implications. J Visc Surg, 2014, 151(2): 117-124.
12.	Ishizawa T, Masuda K, Urano Y, et al. Mechanistic background and clinical applications of indocyanine green fluorescence imaging of hepatocellular carcinoma. Ann Surg Oncol, 2014, 21(2): 440-448.
13.	中华人民共和国国家卫生和计划生育委员会. 原发性肝癌诊疗规范(2017年版). 临床肝胆病杂志, 2017, 33(8): 114-126.
14.	Couinaud C, Le Foie. Etudes anatomiqes et chirugicales. Paris: Masson, 1957: 284-289.
15.	Takasaki K. New concept of liver segmentation on the basis of the Glissonean pedicle (Takasaki’s segmentation)//Takasaki K. Glissonean pedicle transection method for hepatic resection. Japan: Springer, 2007: 7-16.
16.	El-Serag HB. Hepatocellular carcinoma. N Engl J Med, 2011, 365(12): 1118-1127.
17.	Wang FS, Fan JG, Zhang Z, et al. The global burden of liver disease: the major impact of China. Hepatology, 2014, 60(6): 2099-2108.
18.	Hashizume M, Shimada M, Sugimachi K. Laparoscopic hepatectomy: new approach for hepatocellular carcinoma. J Hepatobiliary Pancreat Surg, 2000, 7(3): 270-275.
19.	Kang SH, Kim KH, Shin MH, et al. Surgical outcomes following laparoscopic major hepatectomy for various liver diseases. Medicine (Baltimore), 2016, 95(43): e5182.
20.	Kim WJ, Kim KH, Shin MH, et al. Totally laparoscopic anatomical liver resection for centrally located tumors: A single center experience. Medicine (Baltimore), 2017, 96(4): e5560.
21.	Hasegawa K, Kokudo N, Imamura H, et al. Prognostic impact of anatomic resection for hepatocellular carcinoma. Ann Surg, 2005, 242(2): 252-259.
22.	Viganò L, Tayar C, Laurent A, et al. Laparoscopic liver resection: a systematic review. J Hepatobiliary Pancreat Surg, 2009, 16(4): 410-421.
23.	Buell JF, Cherqui D, Geller DA, et al. The international position on laparoscopic liver surgery: The Louisville Statement, 2008. Ann Surg, 2009, 250(5): 825-830.
24.	Nguyen KT, Gamblin TC, Geller DA. World review of laparoscopic liver resection—2 804 patients. Ann Surg, 2009, 250(5): 831-841.
25.	Koffron AJ, Auffenberg G, Kung R, et al. Evaluation of 300 minimally invasive liver resections at a single institution: less is more. Ann Surg, 2007, 246(3): 385-392.
26.	刘允怡, 余俊豪. 肝段为本的肝切除手术. 中华普通外科杂志, 2003, 18(2): 123-125.
27.	杨甲梅, 谢峰. 肝切除术中肝血流阻断方法的选择. 中国普通外科杂志, 2009, 18(7): 657-660.
28.	李秀军, 李文晓, 耿建利, 等. Glisson蒂横断式肝切除术的临床应用体会. 中国现代普通外科进展, 2013, 16(10): 803-805.
29.	刘允怡, 赖俊雄, 刘晓欣. 肝血流阻断技术在肝切除中的应用. 中国实用外科杂志, 2010, 30(8): 625-626.
30.	Numata K, Morimoto M, Ogura T, et al. Ablation therapy guided by contrast-enhanced sonography with Sonazoid for hepatocellular carcinoma lesions not detected by conventional sonography. J Ultrasound Med, 2008, 27(3): 395-406.
31.	Kitai T, Inomoto T, Miwa M, et al. Fluorescence navigation with indocyanine green for detecting sentinel lymph nodes in breast cancer. Breast Cancer, 2005, 12(3): 211-215.
32.	Kusano M, Tajima Y, Yamazaki K, et al. Sentinel node mapping guided by indocyanine green fluorescence imaging: a new method for sentinel node navigation surgery in gastrointestinal cancer. Dig Surg, 2008, 25(2): 103-108.
33.	Marano A, Priora F, Lenti LM, et al. Application of fluorescence in robotic general surgery: review of the literature and state of the art. World J Surg, 2013, 37(12): 2800-2811.
34.	Gotoh K, Yamada T, Ishikawa O, et al. A novel image-guided surgery of hepatocellular carcinoma by indocyanine green fluorescence imaging navigation. J Surg Oncol, 2009, 100(1): 75-79.
35.	Kudo H, Ishizawa T, Tani K, et al. Visualization of subcapsular hepatic malignancy by indocyanine-green fluorescence imaging during laparoscopic hepatectomy. Surg Endosc, 2014, 28(8): 2504-2508.
36.	Aoki T, Yasuda D, Shimizu Y, et al. Image-guided liver mapping using fluorescence navigation system with indocyanine green for anatomical hepatic resection. World J Surg, 2008, 32(8): 1763-1767.
37.	Aoki T, Murakami M, Yasuda D, et al. Intraoperative fluorescent imaging using indocyanine green for liver mapping and cholangiography. J Hepatobiliary Pancreat Sci, 2010, 17(5): 590-594.
38.	Uchiyama K, Ueno M, Ozawa S, et al. Combined intraoperative use of contrast-enhanced ultrasonography imaging using a sonazoid and fluorescence navigation system with indocyanine green during anatomical hepatectomy. Langenbecks Arch Surg, 2011, 396(7): 1101-1107.
39.	刘冰, 董家鸿. ICG荧光显像技术在肝脏恶性肿瘤切除手术中的应用研究. 解放军医学院, 2016.
40.	梁宾勇, 黄志勇. 原发性肝癌外科治疗方法选择及术后肿瘤复发防治的临床和实验研究. 华中科技大学, 2012.
41.	Miyata A, Ishizawa T, Kamiya M, et al. Photoacoustic tomography of human hepatic malignancies using intraoperative indocyanine green fluorescence imaging. PLoS One, 2014, 9(11): e112667.
42.	Tanaka R, Nakashima K, Fijimoto W. Sentinel lymph node detection in skin cancer using fluorescence navigation with indocyanine green. Dermatol, 2009, 36(8): 468-470.
43.	Nakamura Y, Fujisawa Y, Nakamura Y, et al. Improvement of the sentinel lymph node detection rate of cervical sentinel lymph node biopsy using real-time fluorescence navigation with indocyanine green in head and neck skin cancer. J Dermatol, 2013, 40(6): 453-457.
44.	Ishizawa T, Zuker NB, Kokudo N, et al. Positive and negative staining of hepatic segments by use of fluorescent imaging techniques during laparoscopic hepatectomy. Arch Surg, 2012, 147(4): 393-394.
45.	Sakoda M, Ueno S, Iino S, et al. Anatomical laparoscopic hepatectomy for hepatocellular carcinoma using indocyanine green fluorescence imaging. J Laparoendosc Adv Surg Tech A, 2014, 24(12): 878-882.

1. Reich H, McGlynn F, DeCaprio J, et al. Laparoscopic excision of benign liver lesions. Obstet Gynecol, 1991, 78(5 Pt 2): 956-958.
2. Takasaki K. Glissonean pedicle transection method for hepatic resection: a new concept of liver segmentation. J Hepatobiliary Pancreat Surg, 1998, 5(3): 286-291.
3. Topal B, Aerts R, Penninckx F. Laparoscopic intrahepatic Glissonian approach for right hepatectomy is safe, simple, and reproducible. Surg Endosc, 2007, 21(11): 2111.
4. Cho A, Asano T, Yamamoto H, et al. Laparoscopy-assisted hepatic lobectomy using hilar Glissonean pedicle transection. Surg Endosc, 2007, 21(8): 1466-1468.
5. Ikeda T, Yonemura Y, Ueda N, et al. Pure laparoscopic right hepatectomy in the semi-prone position using the intrahepatic Glissonian approach and a modified hanging maneuver to minimize intraoperative bleeding. Surg Today, 2011, 41(12): 1592-1598.
6. Machado MA, Surjan RC, Makdissi FF. Video: intrahepatic Glissonian approach for pure laparoscopic right hemihepatectomy. Surg Endosc, 2011, 25(12): 3930-3933.
7. Machado MA, Kalil AN. Glissonian approach for laparoscopic mesohepatectomy. Surg Endosc, 2011, 25(6): 2020-2022.
8. Landsman ML, Kwant G, Mook GA, et al. Light-absorbing properties, stability, and spectral stabilization of indocyanine green. J Appl Physiol, 1976, 40(4): 575-583.
9. Abo T, Nanashima A, Tobinaga S, et al. Usefulness of intraoperative diagnosis of hepatic tumors located at the liver surface and hepatic segmental visualization using indocyanine green-photodynamic eye imaging. Eur J Surg Oncol, 2015, 41(2): 257-264.
10. Ishizawa T, Fukushima N, Shibahara J, et al. Real-time identification of liver cancers by using indocyanine green fluorescent imaging. Cancer, 2009, 115(11): 2491-2504.
11. Lim C, Vibert E, Azoulay D, et al. Indocyanine green fluorescence imaging in the surgical management of liver cancers: current facts and future implications. J Visc Surg, 2014, 151(2): 117-124.
12. Ishizawa T, Masuda K, Urano Y, et al. Mechanistic background and clinical applications of indocyanine green fluorescence imaging of hepatocellular carcinoma. Ann Surg Oncol, 2014, 21(2): 440-448.
13. 中华人民共和国国家卫生和计划生育委员会. 原发性肝癌诊疗规范(2017年版). 临床肝胆病杂志, 2017, 33(8): 114-126.
14. Couinaud C, Le Foie. Etudes anatomiqes et chirugicales. Paris: Masson, 1957: 284-289.
15. Takasaki K. New concept of liver segmentation on the basis of the Glissonean pedicle (Takasaki’s segmentation)//Takasaki K. Glissonean pedicle transection method for hepatic resection. Japan: Springer, 2007: 7-16.
16. El-Serag HB. Hepatocellular carcinoma. N Engl J Med, 2011, 365(12): 1118-1127.
17. Wang FS, Fan JG, Zhang Z, et al. The global burden of liver disease: the major impact of China. Hepatology, 2014, 60(6): 2099-2108.
18. Hashizume M, Shimada M, Sugimachi K. Laparoscopic hepatectomy: new approach for hepatocellular carcinoma. J Hepatobiliary Pancreat Surg, 2000, 7(3): 270-275.
19. Kang SH, Kim KH, Shin MH, et al. Surgical outcomes following laparoscopic major hepatectomy for various liver diseases. Medicine (Baltimore), 2016, 95(43): e5182.
20. Kim WJ, Kim KH, Shin MH, et al. Totally laparoscopic anatomical liver resection for centrally located tumors: A single center experience. Medicine (Baltimore), 2017, 96(4): e5560.
21. Hasegawa K, Kokudo N, Imamura H, et al. Prognostic impact of anatomic resection for hepatocellular carcinoma. Ann Surg, 2005, 242(2): 252-259.
22. Viganò L, Tayar C, Laurent A, et al. Laparoscopic liver resection: a systematic review. J Hepatobiliary Pancreat Surg, 2009, 16(4): 410-421.
23. Buell JF, Cherqui D, Geller DA, et al. The international position on laparoscopic liver surgery: The Louisville Statement, 2008. Ann Surg, 2009, 250(5): 825-830.
24. Nguyen KT, Gamblin TC, Geller DA. World review of laparoscopic liver resection—2 804 patients. Ann Surg, 2009, 250(5): 831-841.
25. Koffron AJ, Auffenberg G, Kung R, et al. Evaluation of 300 minimally invasive liver resections at a single institution: less is more. Ann Surg, 2007, 246(3): 385-392.
26. 刘允怡, 余俊豪. 肝段为本的肝切除手术. 中华普通外科杂志, 2003, 18(2): 123-125.
27. 杨甲梅, 谢峰. 肝切除术中肝血流阻断方法的选择. 中国普通外科杂志, 2009, 18(7): 657-660.
28. 李秀军, 李文晓, 耿建利, 等. Glisson蒂横断式肝切除术的临床应用体会. 中国现代普通外科进展, 2013, 16(10): 803-805.
29. 刘允怡, 赖俊雄, 刘晓欣. 肝血流阻断技术在肝切除中的应用. 中国实用外科杂志, 2010, 30(8): 625-626.
30. Numata K, Morimoto M, Ogura T, et al. Ablation therapy guided by contrast-enhanced sonography with Sonazoid for hepatocellular carcinoma lesions not detected by conventional sonography. J Ultrasound Med, 2008, 27(3): 395-406.
31. Kitai T, Inomoto T, Miwa M, et al. Fluorescence navigation with indocyanine green for detecting sentinel lymph nodes in breast cancer. Breast Cancer, 2005, 12(3): 211-215.
32. Kusano M, Tajima Y, Yamazaki K, et al. Sentinel node mapping guided by indocyanine green fluorescence imaging: a new method for sentinel node navigation surgery in gastrointestinal cancer. Dig Surg, 2008, 25(2): 103-108.
33. Marano A, Priora F, Lenti LM, et al. Application of fluorescence in robotic general surgery: review of the literature and state of the art. World J Surg, 2013, 37(12): 2800-2811.
34. Gotoh K, Yamada T, Ishikawa O, et al. A novel image-guided surgery of hepatocellular carcinoma by indocyanine green fluorescence imaging navigation. J Surg Oncol, 2009, 100(1): 75-79.
35. Kudo H, Ishizawa T, Tani K, et al. Visualization of subcapsular hepatic malignancy by indocyanine-green fluorescence imaging during laparoscopic hepatectomy. Surg Endosc, 2014, 28(8): 2504-2508.
36. Aoki T, Yasuda D, Shimizu Y, et al. Image-guided liver mapping using fluorescence navigation system with indocyanine green for anatomical hepatic resection. World J Surg, 2008, 32(8): 1763-1767.
37. Aoki T, Murakami M, Yasuda D, et al. Intraoperative fluorescent imaging using indocyanine green for liver mapping and cholangiography. J Hepatobiliary Pancreat Sci, 2010, 17(5): 590-594.
38. Uchiyama K, Ueno M, Ozawa S, et al. Combined intraoperative use of contrast-enhanced ultrasonography imaging using a sonazoid and fluorescence navigation system with indocyanine green during anatomical hepatectomy. Langenbecks Arch Surg, 2011, 396(7): 1101-1107.
39. 刘冰, 董家鸿. ICG荧光显像技术在肝脏恶性肿瘤切除手术中的应用研究. 解放军医学院, 2016.
40. 梁宾勇, 黄志勇. 原发性肝癌外科治疗方法选择及术后肿瘤复发防治的临床和实验研究. 华中科技大学, 2012.
41. Miyata A, Ishizawa T, Kamiya M, et al. Photoacoustic tomography of human hepatic malignancies using intraoperative indocyanine green fluorescence imaging. PLoS One, 2014, 9(11): e112667.
42. Tanaka R, Nakashima K, Fijimoto W. Sentinel lymph node detection in skin cancer using fluorescence navigation with indocyanine green. Dermatol, 2009, 36(8): 468-470.
43. Nakamura Y, Fujisawa Y, Nakamura Y, et al. Improvement of the sentinel lymph node detection rate of cervical sentinel lymph node biopsy using real-time fluorescence navigation with indocyanine green in head and neck skin cancer. J Dermatol, 2013, 40(6): 453-457.
44. Ishizawa T, Zuker NB, Kokudo N, et al. Positive and negative staining of hepatic segments by use of fluorescent imaging techniques during laparoscopic hepatectomy. Arch Surg, 2012, 147(4): 393-394.
45. Sakoda M, Ueno S, Iino S, et al. Anatomical laparoscopic hepatectomy for hepatocellular carcinoma using indocyanine green fluorescence imaging. J Laparoendosc Adv Surg Tech A, 2014, 24(12): 878-882.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Laparoscopic Glissonean pedicle transection anatomic hepatectomy using indocyanine green fluorescence imaging technology

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