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：

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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.	謝國偉, 吳泓. 吲哚菁綠熒光顯像技術打開“肝臟四扇門”在腹腔鏡精準肝切除中的應用. 腹部外科, 2020, 33(3): 184-189.
6.	中華人民共和國國家衛生和計劃生育委員會. 原發性肝癌診療規范(2017年版). 臨床肝膽病雜志, 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.	中國抗癌協會肝癌專業委員會. 原發性肝癌規范化診治的專家共識. 實用肝臟病雜志, 2009, 12(5): 321-328.
9.	劉袁君, 吳泓, 曾勇, 等. 腔鏡超聲聯合熒光顯像在腹腔鏡肝切除術中的應用. 中國普外基礎與臨床雜志, 2020, 27(6): 662-665.
10.	劉袁君, 吳泓, 曾勇, 等. 經“肝臟四扇門”入路在腹腔鏡解剖性肝切除術中的應用價值. 中華消化外科雜志, 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.	王寧, 鄭金利, 蔣利. 手術切除與射頻消融治療符合米蘭標準的不同肝段多發肝癌的效果分析. 臨床肝膽病雜志, 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.	蔣鷗, 劉宇, 吳文建, 等. 脾與殘肝體積比在肝癌外科中的臨床意義. 中國普外基礎與臨床雜志, 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. 謝國偉, 吳泓. 吲哚菁綠熒光顯像技術打開“肝臟四扇門”在腹腔鏡精準肝切除中的應用. 腹部外科, 2020, 33(3): 184-189.
6. 中華人民共和國國家衛生和計劃生育委員會. 原發性肝癌診療規范(2017年版). 臨床肝膽病雜志, 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. 中國抗癌協會肝癌專業委員會. 原發性肝癌規范化診治的專家共識. 實用肝臟病雜志, 2009, 12(5): 321-328.
9. 劉袁君, 吳泓, 曾勇, 等. 腔鏡超聲聯合熒光顯像在腹腔鏡肝切除術中的應用. 中國普外基礎與臨床雜志, 2020, 27(6): 662-665.
10. 劉袁君, 吳泓, 曾勇, 等. 經“肝臟四扇門”入路在腹腔鏡解剖性肝切除術中的應用價值. 中華消化外科雜志, 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. 王寧, 鄭金利, 蔣利. 手術切除與射頻消融治療符合米蘭標準的不同肝段多發肝癌的效果分析. 臨床肝膽病雜志, 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. 蔣鷗, 劉宇, 吳文建, 等. 脾與殘肝體積比在肝癌外科中的臨床意義. 中國普外基礎與臨床雜志, 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

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