• Department of Liver Surgery, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
WEI Yonggang, Email: yourwyg@163.com
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Objective To investigate the clinical value of three-dimensional reconstruction of liver and resection of hepatocellular carcinoma with indocyanine green (ICG) fluorescence staining. Methods Clinical data of a patient with hepatocellular carcinoma admitted to the Department of Liver Surgery of West China Hospital of Sichuan University in May 2021 were retrospectively collected. In this patient, intrahepatic vascular reconstruction was performed by SYNAPSE 3D software of Japan before operation, and the portal vein and hepatic vein corresponding to the tumor were analyzed to simulate the resection range. Intraoperative ICG fluorescence staining was used to perform laparoscopic resection of segment Ⅳ of the liver.Results In this patient, the fluorescence boundary on the liver surface was clear after staining, and the intrahepatic segment fluorescence interface could still be maintained in the hepatic parenchyma dissociation, and the resection of the liver segment was consistent with the preoperative three-dimensional reconstruction plan. The operation took 230 min in total, and the bleeding was about 200 mL. On the first day after the operation, blood biochemical test showed that the plasma albumin was slightly low, and no obvious abnormalities were observed in transaminase, bilirubin, etc. After the infusion of human albumin, the indexes returned to normal, and the patient recovered and was discharged on the fourth day after the operation. No complications occurred after the operation, and no tumor recurrence and metastasis were observed during follow-up period. Conclusion 3D reconstruction and ICG fluorescence guidance are safe and feasible for the treatment of hepatocellular carcinoma after laparoscopic anatomic segment Ⅳ resection, and the positive staining method of ICG fluorescence segment is recommended.

Citation: WANG Xiaobo, WEI Yonggang. Laparoscopic anatomic segment Ⅳ hepatectomy based on three-dimensional reconstruction and ICG fluorescence guidance. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2021, 28(12): 1632-1636. doi: 10.7507/1007-9424.202107004 Copy

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