Abstract:
Objective To explore the effect of indocyanine green fluorescence (ICG) imaging in combination with laparoscopic hepatectomy in patients with primary liver cancer (PLC).
Methods Data of 78 PLC patients admitted from October 2021 to October 2023 were retrospectively analyzed, and divided into control group (n=38, laparoscopic hepatectomy) and combination group (n=40, ICG+ laparoscopic hepatectomy) according to different treatment methods. The statistical software SPSS 26.0 was used, and the measurement data of liver and kidney function, inflammatory factors and stress indexes were measured by independent t test. The curative effect was tested by rank sum test. The statistical data of postoperative complications were compared by χ2 test. P<0.05 was considered statistically significant.
Results There was no statistical significance in preoperative (T0) liver function between 2 groups (P>0.05). At 1 day (T1) after surgery, alanine aminotransferase (ALT), aspartate aminotransferase (AST) and total bilirubin (TBIL) in 2 groups were higher than T0, and serum albumin (ALB) was lower than T0 (P<0.05). One month after surgery (T30), serum albumin in both groups was increased, but still lower than T0 (P<0.05), while ALT, AST and TBIL basically recovered to T0 levels (P<0.05). At T30, the objective response rate (ORR) and disease control rate (DCR) of the combined group had no statistical significance (P>0.05), but at 3 months after surgery, the ORR and DCR of the combined group were 90.0% and 92.5%, respectively, which were higher than 65.8% and 76.3% of the control group (P<0.05). At T1, interleukin-6 (IL-6), C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), cortisol (Cor) and epinephrine (E) in 2 groups were increased compared with T0 (P<0.05), but the combined group was lower than the control group (P<0.05). Compared with T1, at T30, IL-6, CRP, TNF-α, Cor and E in both groups were decreased (P<0.05), and basically recovered to T0 level (P<0.05). Compared with control group, the total incidence of fever caused by bile leakage, blood seepage and encapsulated effusion was lower in combination group (P<0.05).
Conclusion ICG fluorescence imaging combined with laparoscopic hepatectomy in the treatment of PLC is safe and effective, and has a good improvement in inflammatory factors and stress indexes.
Key words:
Primary Liver Cancer,
Laparoscopic Hepatectomy,
Indocyanine Green Fluorescence Imaging,
Inflammation,
Stress Indicators
Mei Tang, Li Zhou, Cenyue Niu, Xiaotong Zhou, Qian Wang. Clinical significance of ICG fluorescence guided laparoscopic hepatectomy[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(06): 655-658.