Laparoscopic precise segment <b>Ⅳ</b> hepatectomy by guiding of indocyanine green fluorescence imaging <i>via</i> ligamenta teres hepatis: a summary of 6 cases_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

ZHENG Jinli , JIANG Li , WU Hong ,  LI Jiaxin

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

Corresponding author：

LI Jiaxin, Email: 407723080@qq.com

Keywords：

ligamenta teres hepatis; indocyanine green; hepatectomy; laparoscope

DOI：

10.7507/1007-9424.202201053

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To investigate the clinical feasibility and value of laparoscopic precise segment Ⅳ hepatectomy by guiding of indocyanine green (ICG) fluorescence imaging via ligamenta teres hepatis. Method The clinicopathologic data of patients with liver cancer treated in the Department of Liver Surgery of West China Hospital of Sichuan University from January 2017 to December 2021 who underwent precise segment Ⅳ hepatectomy by the guidance of ICG fluorescence imaging through the ligamenta teres hepatis were collected retrospectively. Results A total of 6 patients were collected, including 5 males and 1 female. The age ranged from 42 to 78 years. All 6 patients were successfully completed using laparoscopic precise segment Ⅳ hepatectomy by guiding of ICG fluorescence imaging via ligamenta teres hepatis. The operation time was (200±30) min, the intraoperative bleeding was (100±20) mL, and there were no intraoperative blood transfusion, postoperative liver failure, postoperative pneumonia, incision infection, bile leakage, postoperative bleeding, and other complications. The postoperative hospital stay was (7±2) d. One patient with positive microvascular invasion was found after operation and recurred at 38 months after operation, then treated by radiofrequency ablation and didn’t recur. No patient died during the follow-up period in 6 patients. Conclusion From results of limited cases in this study, laparoscopic precise segment Ⅳ hepatectomy by guiding of ICG fluorescence imaging via ligamenta teres hepatis is safe, feasible, and effective.

Citation： ZHENG Jinli, JIANG Li, WU Hong, LI Jiaxin. Laparoscopic precise segment Ⅳ hepatectomy by guiding of indocyanine green fluorescence imaging via ligamenta teres hepatis: a summary of 6 cases. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2022, 29(4): 426-430. doi: 10.7507/1007-9424.202201053 Copy

1.	Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2021, 71(3): 209-249.
2.	Mazzaferro V, Regalia E, Doci R, et al. Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis. N Engl J Med, 1996, 334(11): 693-699.
3.	Ishizawa T, Hasegawa K, Aoki T, et al. Neither multiple tumors nor portal hypertension are surgical contraindications for hepatocellular carcinoma. Gastroenterology, 2008, 134(7): 1908-1916.
4.	Terasawa M, Ishizawa T, Mise Y, et al. Applications of fusion-fluorescence imaging using indocyanine green in laparoscopic hepatectomy. Surg Endosc, 2017, 31(12): 5111-5118.
5.	谢国伟, 吴泓. 吲哚菁绿荧光显像技术打开“肝脏四扇门”在腹腔镜精准肝切除中的应用. 腹部外科, 2020, 33(3): 184-189.
6.	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): 1419-1431.
7.	Pang YY. The Brisbane 2000 terminology of liver anatomy and resections. HPB 2000, 2: 333-339. HPB (Oxford), 2002, 4(2): 99. doi: 10.1080/136518202760378489.
8.	中国抗癌协会肝癌专业委员会. 原发性肝癌规范化诊治的专家共识. 实用肝脏病杂志, 2009, 12(5): 321-328.
9.	刘袁君, 吴泓, 曾勇, 等. 腔镜超声联合荧光显像在腹腔镜肝切除术中的应用. 中国普外基础与临床杂志, 2020, 27(6): 662-665.
10.	刘袁君, 吴泓, 曾勇, 等. 经“肝脏四扇门”入路在腹腔镜解剖性肝切除术中的应用价值. 中华消化外科杂志, 2020, 19(8): 876-881.
11.	Zheng K, He D, Liao A, et al. Laparoscopic segmentectomy Ⅳ using hepatic round ligament approach combined with fluorescent negative staining method. Ann Surg Oncol, 2022 Jan 7. doi: 10.1245/s10434-021-11221-5.
12.	Xie KL, Zeng Y, Wu H. Hepatic trisectionectomy for hepatocellular carcinoma using the Glisson pedicle method combined with anterior approach. World J Surg, 2014, 38(9): 2358-2362.
13.	王宁, 郑金利, 蒋利. 手术切除与射频消融治疗符合米兰标准的不同肝段多发肝癌的效果分析. 临床肝胆病杂志, 2020, 36(4): 792-797.
14.	Trotter JF. Liver transplantation around the world. Curr Opin Organ Transplant, 2017, 22(2): 123-127.
15.	de Lope CR, Tremosini S, Forner A, et al. Management of HCC. J Hepatol, 2012, 56 Suppl 1: S75-S87. doi: 10.1016/S0168-8278(12)60009-9.
16.	Forner A, Llovet JM, Bruix J. Hepatocellular carcinoma. Lancet, 2012, 379(9822): 1245-1255.
17.	Méndez-Sánchez N, Ridruejo E, Alves de Mattos A, et al. Latin American Association for the Study of the Liver (LAASL) clinical practice guidelines: management of hepatocellular carcinoma. Ann Hepatol, 2014, 13 Suppl 1: S4-S40. https://doi.org/10.1016/S1665-2681(19)30919-6.
18.	Moris D, Tsilimigras DI, Kostakis ID, et al. Anatomic versus non-anatomic resection for hepatocellular carcinoma: a systematic review and meta-analysis. Eur J Surg Oncol, 2018, 44(7): 927-938.
19.	Jiao S, Li G, Zhang D, et al. Anatomic versus non-anatomic resection for hepatocellular carcinoma, do we have an answer? A meta-analysis. Int J Surg, 2020, 80: 243-255.
20.	蒋鸥, 刘宇, 吴文建, 等. 脾与残肝体积比在肝癌外科中的临床意义. 中国普外基础与临床杂志, 2011, 18(5): 528-532.
21.	Imura S, Teraoku H, Yoshikawa M, et al. Potential predictive factors for microvascular invasion in hepatocellular carcinoma classified within the Milan criteria. Int J Clin Oncol, 2018, 23(1): 98-103.
22.	Adachi E, Maehara S, Tsujita E, et al. Clinicopathologic risk factors for recurrence after a curative hepatic resection for hepatocellular carcinoma. Surgery, 2002, 131(1 Suppl): S148-S152. doi: 10.1067/msy.2002.119496.
23.	Zhang X, Li J, Shen F, et al. Significance of presence of microvascular invasion in specimens obtained after surgical treatment of hepatocellular carcinoma. J Gastroenterol Hepatol, 2018, 33(2): 347-354.
24.	Rodríguez-Perálvarez M, Luong TV, Andreana L, et al. A systematic review of microvascular invasion in hepatocellular carcinoma: diagnostic and prognostic variability. Ann Surg Oncol, 2013, 20(1): 325-339.
25.	Zhang X, Li C, Wen T, et al. Appropriate treatment strategies for intrahepatic recurrence after curative resection of hepatocellular carcinoma initially within the Milan criteria: according to the recurrence pattern. Eur J Gastroenterol Hepatol, 2015, 27(8): 933-940.
26.	Gao J, Wang SH, Ding XM, et al. Radiofrequency ablation for single hepatocellular carcinoma 3 cm or less as first-line treatment. World J Gastroenterol, 2015, 21(17): 5287-5294.
27.	Lam VW, Ng KK, Chok KS, et al. Risk factors and prognostic factors of local recurrence after radiofrequency ablation of hepatocellular carcinoma. J Am Coll Surg, 2008, 207(1): 20-29.

1. Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2021, 71(3): 209-249.
2. Mazzaferro V, Regalia E, Doci R, et al. Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis. N Engl J Med, 1996, 334(11): 693-699.
3. Ishizawa T, Hasegawa K, Aoki T, et al. Neither multiple tumors nor portal hypertension are surgical contraindications for hepatocellular carcinoma. Gastroenterology, 2008, 134(7): 1908-1916.
4. Terasawa M, Ishizawa T, Mise Y, et al. Applications of fusion-fluorescence imaging using indocyanine green in laparoscopic hepatectomy. Surg Endosc, 2017, 31(12): 5111-5118.
5. 谢国伟, 吴泓. 吲哚菁绿荧光显像技术打开“肝脏四扇门”在腹腔镜精准肝切除中的应用. 腹部外科, 2020, 33(3): 184-189.
6. 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): 1419-1431.
7. Pang YY. The Brisbane 2000 terminology of liver anatomy and resections. HPB 2000, 2: 333-339. HPB (Oxford), 2002, 4(2): 99. doi: 10.1080/136518202760378489.
8. 中国抗癌协会肝癌专业委员会. 原发性肝癌规范化诊治的专家共识. 实用肝脏病杂志, 2009, 12(5): 321-328.
9. 刘袁君, 吴泓, 曾勇, 等. 腔镜超声联合荧光显像在腹腔镜肝切除术中的应用. 中国普外基础与临床杂志, 2020, 27(6): 662-665.
10. 刘袁君, 吴泓, 曾勇, 等. 经“肝脏四扇门”入路在腹腔镜解剖性肝切除术中的应用价值. 中华消化外科杂志, 2020, 19(8): 876-881.
11. Zheng K, He D, Liao A, et al. Laparoscopic segmentectomy Ⅳ using hepatic round ligament approach combined with fluorescent negative staining method. Ann Surg Oncol, 2022 Jan 7. doi: 10.1245/s10434-021-11221-5.
12. Xie KL, Zeng Y, Wu H. Hepatic trisectionectomy for hepatocellular carcinoma using the Glisson pedicle method combined with anterior approach. World J Surg, 2014, 38(9): 2358-2362.
13. 王宁, 郑金利, 蒋利. 手术切除与射频消融治疗符合米兰标准的不同肝段多发肝癌的效果分析. 临床肝胆病杂志, 2020, 36(4): 792-797.
14. Trotter JF. Liver transplantation around the world. Curr Opin Organ Transplant, 2017, 22(2): 123-127.
15. de Lope CR, Tremosini S, Forner A, et al. Management of HCC. J Hepatol, 2012, 56 Suppl 1: S75-S87. doi: 10.1016/S0168-8278(12)60009-9.
16. Forner A, Llovet JM, Bruix J. Hepatocellular carcinoma. Lancet, 2012, 379(9822): 1245-1255.
17. Méndez-Sánchez N, Ridruejo E, Alves de Mattos A, et al. Latin American Association for the Study of the Liver (LAASL) clinical practice guidelines: management of hepatocellular carcinoma. Ann Hepatol, 2014, 13 Suppl 1: S4-S40. https://doi.org/10.1016/S1665-2681(19)30919-6.
18. Moris D, Tsilimigras DI, Kostakis ID, et al. Anatomic versus non-anatomic resection for hepatocellular carcinoma: a systematic review and meta-analysis. Eur J Surg Oncol, 2018, 44(7): 927-938.
19. Jiao S, Li G, Zhang D, et al. Anatomic versus non-anatomic resection for hepatocellular carcinoma, do we have an answer? A meta-analysis. Int J Surg, 2020, 80: 243-255.
20. 蒋鸥, 刘宇, 吴文建, 等. 脾与残肝体积比在肝癌外科中的临床意义. 中国普外基础与临床杂志, 2011, 18(5): 528-532.
21. Imura S, Teraoku H, Yoshikawa M, et al. Potential predictive factors for microvascular invasion in hepatocellular carcinoma classified within the Milan criteria. Int J Clin Oncol, 2018, 23(1): 98-103.
22. Adachi E, Maehara S, Tsujita E, et al. Clinicopathologic risk factors for recurrence after a curative hepatic resection for hepatocellular carcinoma. Surgery, 2002, 131(1 Suppl): S148-S152. doi: 10.1067/msy.2002.119496.
23. Zhang X, Li J, Shen F, et al. Significance of presence of microvascular invasion in specimens obtained after surgical treatment of hepatocellular carcinoma. J Gastroenterol Hepatol, 2018, 33(2): 347-354.
24. Rodríguez-Perálvarez M, Luong TV, Andreana L, et al. A systematic review of microvascular invasion in hepatocellular carcinoma: diagnostic and prognostic variability. Ann Surg Oncol, 2013, 20(1): 325-339.
25. Zhang X, Li C, Wen T, et al. Appropriate treatment strategies for intrahepatic recurrence after curative resection of hepatocellular carcinoma initially within the Milan criteria: according to the recurrence pattern. Eur J Gastroenterol Hepatol, 2015, 27(8): 933-940.
26. Gao J, Wang SH, Ding XM, et al. Radiofrequency ablation for single hepatocellular carcinoma 3 cm or less as first-line treatment. World J Gastroenterol, 2015, 21(17): 5287-5294.
27. Lam VW, Ng KK, Chok KS, et al. Risk factors and prognostic factors of local recurrence after radiofrequency ablation of hepatocellular carcinoma. J Am Coll Surg, 2008, 207(1): 20-29.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Laparoscopic precise segment Ⅳ hepatectomy by guiding of indocyanine green fluorescence imaging via ligamenta teres hepatis: a summary of 6 cases

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content