外科理论与实践2025，Vol.30Issue(4)：325-331,7.DOI:10.16139/j.1007-9610.2025.04.06
吲哚菁绿荧光影像技术对原发性肝癌手术治疗的指导价值以及近期预后分析
Assessment of indocyanine green fluorescence imaging in hepatectomy for primary liver carcinoma:short-term prognostic analysis
摘要
Abstract
Objective To explore the efficiency of indocyanine green(ICG)fluorescence imaging-guided hepatectomy and its short-term prognosis in patients with primary liver carcinoma.Methods Retrospective analysis was conducted on 166 patients diagnosed with primary liver carcinoma and admitted to the Department of Hepatobiliary Surgery of Shanghai General Hospital affiliated to Shanghai Jiao Tong University School of Medicine from June 2018 to June 2021.Patients were categorized into ICG group(n=72)and non-ICG group(n=94)based on the utilization of ICG during surgery.Moreover,the clinical information of preoperation,intraoperation,and postoperation were collected and compared between the two groups.ICG fluorescence images of the lesions in the ICG group were recorded for analysis.Results ICG fluorescence intensity is associated with the histopathology,differentiation grade of primary liver cancer,and the presence of liver cirrhosis.Hepatocellular carcinoma lesions predominantly displayed partial fluorescence,while intrahepatic cholangiocarcinoma lesions showed circular fluorescence.Well differentiated tumors exhibited complete fluorescence(7/11),moderately differentiated tumors demonstrated partial fluorescence(28/51),and poorly differentiated tumors displayed circular fluorescence(7/10).Most patients with liver cirrhosis exhibited partial fluorescence(18/35)or complete fluorescence(13/35).Compared to the non-ICG group,the ICG group demonstrated higher serum albumin levels on the first(34.6 g/L vs.31.4 g/L)and the third postoperative days(32.4 g/L vs.31.2 g/L)(P<0.001).Conversely,the ICG group showed shorter operation time(170 min vs.210 min),lower rate of intraoperative hepatic portal blockade(9.7%vs.33.0%),less intraoperative blood loss(400 mL vs.430 mL),shorter postoperative hospital stay(10 d vs.14 d),and lower incidence of short-term postoperative complications(4.2%vs.20.2%)(P<0.05)compared to the non-ICG group.Conclusions ICG fluorescence intensity is associated with the histopathology,differentiation grade of primary liver cancer,and the presence of liver cirrhosis.The judicious application of ICG fluorescence imaging technology alongside surgical techniques holds promise for improving short-term prognosis and expediting the postoperative recovery.关键词
原发性肝癌/吲哚菁绿/荧光影像/肝切除术Key words
Primary liver carcinoma/Indocyanine green(ICG)/Fluorescence image/Hepatectomy分类
医药卫生引用本文复制引用
黄文欣,何启宁,戚德彬,曹梓超,姜艳芝,王普森,阙伟涛,钟林..吲哚菁绿荧光影像技术对原发性肝癌手术治疗的指导价值以及近期预后分析[J].外科理论与实践,2025,30(4):325-331,7.基金项目
上海市浦江人才计划(22PJD062) （22PJD062）
深圳市高水平医院建设专项经费资助项目(XKJS-PWK-001) （XKJS-PWK-001）
