Laparoscopic anatomic segment Ⅳ hepatectomy based on three-dimensional reconstruction and ICG fluorescence guidance_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

WANG Xiaobo ,  WEI Yonggang

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

Corresponding?author：

WEI Yonggang, Email: yourwyg@163.com

Keywords：

3D reconstruction; indocyanine green; anatomical hepatectomy

DOI：

10.7507/1007-9424.202107004

Video：

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Objective To investigate the clinical value of three-dimensional reconstruction of liver and resection of hepatocellular carcinoma with indocyanine green (ICG) fluorescence staining. Methods Clinical data of a patient with hepatocellular carcinoma admitted to the Department of Liver Surgery of West China Hospital of Sichuan University in May 2021 were retrospectively collected. In this patient, intrahepatic vascular reconstruction was performed by SYNAPSE 3D software of Japan before operation, and the portal vein and hepatic vein corresponding to the tumor were analyzed to simulate the resection range. Intraoperative ICG fluorescence staining was used to perform laparoscopic resection of segment Ⅳ of the liver.Results In this patient, the fluorescence boundary on the liver surface was clear after staining, and the intrahepatic segment fluorescence interface could still be maintained in the hepatic parenchyma dissociation, and the resection of the liver segment was consistent with the preoperative three-dimensional reconstruction plan. The operation took 230 min in total, and the bleeding was about 200 mL. On the first day after the operation, blood biochemical test showed that the plasma albumin was slightly low, and no obvious abnormalities were observed in transaminase, bilirubin, etc. After the infusion of human albumin, the indexes returned to normal, and the patient recovered and was discharged on the fourth day after the operation. No complications occurred after the operation, and no tumor recurrence and metastasis were observed during follow-up period. Conclusion 3D reconstruction and ICG fluorescence guidance are safe and feasible for the treatment of hepatocellular carcinoma after laparoscopic anatomic segment Ⅳ resection, and the positive staining method of ICG fluorescence segment is recommended.

Citation： WANG Xiaobo, WEI Yonggang. Laparoscopic anatomic segment Ⅳ hepatectomy based on three-dimensional reconstruction and ICG fluorescence guidance. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2021, 28(12): 1632-1636. doi: 10.7507/1007-9424.202107004 Copy

1.	Ishizawa T, Gumbs AA, Kokudo N, et al. Laparoscopic segmentectomy of the liver: from segment Ⅰ to Ⅷ. Ann Surg, 2012, 256(6): 959-964.
2.	曾思略, 曾寧, 祝文, 等. 三維可視化聯合吲哚菁綠熒光影像技術在原發性肝癌診治中的價值. 南方醫科大學學報, 2019, 39(12): 1402-1408.
3.	崔楷悅, 董蒨, 耿耿, 等. 基于計算機輔助手術系統的肝靜脈分型及其對肝臟外科的臨床意義. 中華肝膽外科雜志, 2017, 23(9): 585-590.
4.	王宏光. 吲哚菁綠肝段染色在腹腔鏡肝癌切除中應用及意義. 中國實用外科雜志, 2018, 38(4): 376-378.
5.	王鵬飛, 陳明易, 盧實春, 等. 吲哚菁綠熒光引導腹腔鏡解剖性肝臟Ⅵ段切除手術流程. 中華肝膽外科雜志, 2019, 25(3): 228-229.
6.	Ueno M, Hayami S, Sonomura T, et al. Indocyanine green fluorescence imaging techniques and interventional radiology during laparoscopic anatomical liver resection (with video). Surg Endosc, 2018, 32(2): 1051-1055.
7.	王曉穎, 高強, 朱曉東, 等. 腹腔鏡超聲聯合三維可視化技術引導門靜脈穿刺吲哚菁綠熒光染色在精準解剖性肝段切除術中的應用. 中華消化外科雜志, 2018, 17(5): 452-458.
8.	葉鋼, 張濤, 王勛, 等. 腹腔鏡下吲哚菁綠雙熒光染色解剖性肝Ⅳb段切除治療肝細胞癌. 腹部外科, 2020, 33(3): 180-183, 189.
9.	張雯雯, 陳明易, 王宏光. 熒光腹腔鏡解剖性肝臟Ⅵ段切除術1例. 肝癌電子雜志, 2020, 7(2): 73-75.
10.	周磊, 卜浩, 成偉, 等. 腹腔鏡解剖性肝臟Ⅱ段切除手術流程. 中華肝膽外科雜志, 2019, 25(2): 140-141.
11.	王鵬飛, 陳明易, 盧實春, 等. 吲哚菁綠熒光引導腹腔鏡解剖性肝臟Ⅶ段切除手術流程. 中華肝膽外科雜志, 2019, 25(2): 137-139.
12.	劉允怡, 劉曉欣. 三維可視化技術在肝臟外科臨床應用的優勢. 中華外科雜志, 2016, 54(9): 661-663.
13.	劉磊, 趙義軍. 三維重建技術在精準肝切除中的應用進展. 肝膽外科雜志, 2021, 29(1): 74-76.
14.	李鵬鵬, 王志恒, 黃罡, 等. 肝臟三維可視化技術在肝臟惡性腫瘤治療規劃中的應用研究. 中華外科雜志, 2017, 55(12): 916-922.
15.	盧鵬, 王宏光. 吲哚菁綠熒光引導腹腔鏡解剖性肝段切除術. 中華消化外科雜志, 2020, 19(2): 139-144.
16.	李博, 林杰. 肝臟三維重建技術較傳統CT成像技術對腫瘤體積可提供更準確的術前評估. 中國組織工程研究, 2020, 24(11): 1726-1732.
17.	王偉, 胡娟英, 許明輝, 等. 肝臟三維重建術前規劃結合術中超聲引導在腹腔鏡精準肝段切除的臨床效果. 浙江創傷外科, 2021, 26(2): 221-222.
18.	曾思略, 楊劍, 祝文, 等. 三維可視化、虛擬現實技術聯合ICG分子熒光成像在中央型肝癌肝切除術中的應用 (附視頻). 中華肝臟外科手術學電子雜志, 2019, 8(5): 420-425.
19.	季渝軍. 基于Amira軟件的三維立體重建技術在精準肝切除術中的應用研究. 影像科學與光化學, 2020, 38(5): 801-806.
20.	張思琦, 王晶, 陳鐘, 等. 三維影像分析系統在肝臟腫瘤精準切除中的應用研究. 交通醫學, 2020, 34(2): 140-142.
21.	宋研, 張建淮, 禹亞彬, 等. 三維重建可視化技術在精準肝臟外科研究生教學和規范化培訓中的應用. 中國臨床研究, 2020, 33(10): 1403-1406.
22.	白軍軍, 翟振洪, 季德剛, 等. 數字化三維重建技術在肝臟外科中的應用. 醫院與醫學, 2018, 6(2): 14-18.

1. Ishizawa T, Gumbs AA, Kokudo N, et al. Laparoscopic segmentectomy of the liver: from segment Ⅰ to Ⅷ. Ann Surg, 2012, 256(6): 959-964.
2. 曾思略, 曾寧, 祝文, 等. 三維可視化聯合吲哚菁綠熒光影像技術在原發性肝癌診治中的價值. 南方醫科大學學報, 2019, 39(12): 1402-1408.
3. 崔楷悅, 董蒨, 耿耿, 等. 基于計算機輔助手術系統的肝靜脈分型及其對肝臟外科的臨床意義. 中華肝膽外科雜志, 2017, 23(9): 585-590.
4. 王宏光. 吲哚菁綠肝段染色在腹腔鏡肝癌切除中應用及意義. 中國實用外科雜志, 2018, 38(4): 376-378.
5. 王鵬飛, 陳明易, 盧實春, 等. 吲哚菁綠熒光引導腹腔鏡解剖性肝臟Ⅵ段切除手術流程. 中華肝膽外科雜志, 2019, 25(3): 228-229.
6. Ueno M, Hayami S, Sonomura T, et al. Indocyanine green fluorescence imaging techniques and interventional radiology during laparoscopic anatomical liver resection (with video). Surg Endosc, 2018, 32(2): 1051-1055.
7. 王曉穎, 高強, 朱曉東, 等. 腹腔鏡超聲聯合三維可視化技術引導門靜脈穿刺吲哚菁綠熒光染色在精準解剖性肝段切除術中的應用. 中華消化外科雜志, 2018, 17(5): 452-458.
8. 葉鋼, 張濤, 王勛, 等. 腹腔鏡下吲哚菁綠雙熒光染色解剖性肝Ⅳb段切除治療肝細胞癌. 腹部外科, 2020, 33(3): 180-183, 189.
9. 張雯雯, 陳明易, 王宏光. 熒光腹腔鏡解剖性肝臟Ⅵ段切除術1例. 肝癌電子雜志, 2020, 7(2): 73-75.
10. 周磊, 卜浩, 成偉, 等. 腹腔鏡解剖性肝臟Ⅱ段切除手術流程. 中華肝膽外科雜志, 2019, 25(2): 140-141.
11. 王鵬飛, 陳明易, 盧實春, 等. 吲哚菁綠熒光引導腹腔鏡解剖性肝臟Ⅶ段切除手術流程. 中華肝膽外科雜志, 2019, 25(2): 137-139.
12. 劉允怡, 劉曉欣. 三維可視化技術在肝臟外科臨床應用的優勢. 中華外科雜志, 2016, 54(9): 661-663.
13. 劉磊, 趙義軍. 三維重建技術在精準肝切除中的應用進展. 肝膽外科雜志, 2021, 29(1): 74-76.
14. 李鵬鵬, 王志恒, 黃罡, 等. 肝臟三維可視化技術在肝臟惡性腫瘤治療規劃中的應用研究. 中華外科雜志, 2017, 55(12): 916-922.
15. 盧鵬, 王宏光. 吲哚菁綠熒光引導腹腔鏡解剖性肝段切除術. 中華消化外科雜志, 2020, 19(2): 139-144.
16. 李博, 林杰. 肝臟三維重建技術較傳統CT成像技術對腫瘤體積可提供更準確的術前評估. 中國組織工程研究, 2020, 24(11): 1726-1732.
17. 王偉, 胡娟英, 許明輝, 等. 肝臟三維重建術前規劃結合術中超聲引導在腹腔鏡精準肝段切除的臨床效果. 浙江創傷外科, 2021, 26(2): 221-222.
18. 曾思略, 楊劍, 祝文, 等. 三維可視化、虛擬現實技術聯合ICG分子熒光成像在中央型肝癌肝切除術中的應用 (附視頻). 中華肝臟外科手術學電子雜志, 2019, 8(5): 420-425.
19. 季渝軍. 基于Amira軟件的三維立體重建技術在精準肝切除術中的應用研究. 影像科學與光化學, 2020, 38(5): 801-806.
20. 張思琦, 王晶, 陳鐘, 等. 三維影像分析系統在肝臟腫瘤精準切除中的應用研究. 交通醫學, 2020, 34(2): 140-142.
21. 宋研, 張建淮, 禹亞彬, 等. 三維重建可視化技術在精準肝臟外科研究生教學和規范化培訓中的應用. 中國臨床研究, 2020, 33(10): 1403-1406.
22. 白軍軍, 翟振洪, 季德剛, 等. 數字化三維重建技術在肝臟外科中的應用. 醫院與醫學, 2018, 6(2): 14-18.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Laparoscopic anatomic segment Ⅳ hepatectomy based on three-dimensional reconstruction and ICG fluorescence guidance

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