AHBPS
Annals of Hepato-Biliary-Pancreatic Surgerywww.ahbps.org S128
Laparoscopic anatomical subsegmentectomy for hepatocellular carcinoma using
indocyanine green fluorescence imaging
Hye-Sung JO, Young-Dong YU, Dong-Sik KIM*
Department of Surgery, Korea University College of Medicine, Seoul, Korea
VP-3
Introduction: Recently, various types of laparoscopic anatomical liver resection for hepatocellular carcinoma has been actively per- formed in many centers. Indocyanine green (ICG) fluorescence imaging technique has been increasingly used to visualize biliary anatomy and demarcation of the transected area. We demonstrate laparoscopic anatomical subsegmentectomy for hepatocellular car- cinoma using indocyanine green fluorescence imaging technique.
Methods: A 70-year-old female patient with chronic hepatitis B virus-associated hepatocellular carcinoma underwent laparoscopic S5 subsegmentectomy. We identified and divided the Glisson’s pedicle to the tumor with intraoperative ultrasonography. Then, ICG 5 mg (0.1 mg/kg) was administered via the intravenous route. After several seconds, future liver remnant territory was counterstained under a fluorescent microscope (Olympus, Tokyo, Japan). Then, the ventral portion of S5 was transected along with the demarcation line.
Results: ICG fluorescence was well accumulated in the future liver remnant. It provided clearer demarcation than the conventional demarcation technique. The operation time was 200 minutes, and intraoperative blood loss was negligible. All surgical resection mar- gins were confirmed to be negative for tumor cell. She was discharged on the seventh postoperative day without any complication.
Conclusions: Laparoscopic anatomical subsegmentectomy using indocyanine green fluorescence imaging was a feasible procedure. It could contribute to better identification of subsegment indicated by conventional demarcation technique.
pISSN: 2508-5778ㆍeISSN: 2508-5859
Ann Hepatobiliary Pancreat Surg 2021;25 Suppl 1:S128 https://doi.org/10.14701/ahbps.VP-3
Corresponding Author: Dong-Sik KIM ([email protected]) Presenter: Hye-Sung JO ([email protected])
Copyright Ⓒ The Korean Association of Hepato-Biliary-Pancreatic Surgery
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