Application Research of Indocyanine Green Fluorescence in Laparoscopic Hepatectomy for Liver Tumors

Objective :The study aims to discuss the advantages of using indocyanine green(ICG)fluorescence real-time navigation in laparoscopic liver tumor resection. Method :A retrospective study conducted from July 2021 to July 2023 involving 128 patients who underwent laparoscopic liver cancer resection at the Affiliated Hospital of Putian University,of which 73 patients received conventional laparoscopic surgery(non-fluorescence group)and 55 patients underwent laparoscopic surgery guided by ICG navigation(fluorescence group).The differences between the two groups of data were analyzed. Results :In terms of surgical margin,the surgical margin was negative in the fluorescence group(55 cases),and 1 case was positive in the non-fluorescence group(1/73).There was no capsule destruction in the fluorescence group,and there were 3 cases of capsule destruction in the non-fluorescence group(3/73).Abnormal nodules were found in 6 cases(6/55)in the fluorescence group,and 3 cases were positive by pathological diagnosis.From the point of view of metastasis and recurrence rate at 1 year after operation,the recurrence and metastasis rate of the fluorescence group was 7.27%,and the recurrence and metastasis rate of the non-fluorescence group was 10.96%.Compared with the two groups of data,the recurrence and metastasis rate of the fluorescence group had a decreasing trend.Compared with the non-fluorescence group,the amount of bleeding in the fluorescence group was significantly reduced(P < 0.05),and the incidence of bile leakage was reduced(P < 0.05).The above data were statistically significant.Under the near-infrared light camera,the highly differentiated tumors showed complete fluorescence,the moderately differentiated tumors showed partial fluorescence,and the poorly differentiated tumors showed ring fluorescence. Conclusion :The surgical margin can be better determined under the real-time fluorescence navigation of ICG,and the fluorescence type is related to the degree of tumor differentiation.It can effectively reduce the amount of bleeding during operation.Micronodules that are difficult to find by preoperative imaging examination can be found during the operation.It can also facilitate the identification of bile ducts during surgery and reduce the incidence of bile leakage.