目的 比较模拟手术规划（基于术前CT三维重建）联合术中吲哚菁绿（ICG）荧光显像及腹腔镜超声（LUS）引导的多模态导航与仅采用模拟手术规划在腹腔镜精准肝切除术治疗原发性肝癌，对肝功能保留及近期疗效的影响。方法 回顾性分析2021年3月至2024年2月嘉兴市第一医院连续收治的82例原发性肝癌病人的临床资料。按技术应用时间分为：多模态导航组（38例），即2022年9月至2024年2月，接受术前CT三维重建联合术中ICG荧光及LUS引导的病人；单纯规划组（44例），即2021年3月至2022年8月，仅行术前CT三维重建的病人。比较两组病人肝功能（术前、术后1 d、术后7 d）、手术时间、出血量、并发症等指标。结果 多模态导航组与单纯规划组原发性肝癌病人一般资料比较，差异无统计学意义（P>0.05）。术前，两组病人总胆红素、丙氨酸氨基转移酶、天门冬氨酸氨基转移酶、白蛋白水平差异无统计学意义（P>0.05）；术后第7天，两组病人白蛋白水平差异无统计学意义（P>0.05）。多模态导航组病人在术后第1天、第7天的总胆红素、丙氨酸氨基转移酶、天门冬氨酸氨基转移酶指标均低于单纯规划组，术后第1天的白蛋白指标高于单纯规划组，差异均有统计学意义（P<0.05）。多模态导航组手术时间、引流管留置时间和术后住院时间短于单纯规划组，术中出血量少于单纯规划组，输血比例低于单纯规划组，差异有统计学意义（P<0.05）。多模态导航组和单纯规划组病人术后并发症发生率分别为13.2%和31.8%，多模态导航组病人术后并发症发生率低于单纯规划组，差异有统计学意义（P<0.05）。结论 与单一模拟手术规划相比，模拟手术规划联合ICG荧光显像及LUS引导的多模态导航的手术效果更优，在实现精准切除的同时更好地保留肝功能。

Objective To compare the effects of simulated surgical planning (based on preoperative CT three-dimensional reconstruction) combined with multimodal navigation (intraoperative ICG fluorescence and LUS) versus simulated surgical planning alone on liver function preservation and short-term outcomes during laparoscopic precise hepatectomy for primary liver cancer. Methods Clinical data of 82 consecutive patients with primary liver cancer admitted to the First Hospital of Jiaxing City between March 2021 and February 2024 were retrospectively analyzed. According to the period of technology application, patients were divided into a multimodal navigation group, 38 patients who received preoperative CT three-dimensional reconstruction combined with intraoperative indocyanine green fluorescence and laparoscopic ultrasound (LUS) guidance between September 2022 and February 2024, and a planning-only group, 44 patients who received only preoperative CT three-dimensional reconstruction guidance between March 2021 and August 2022. Liver function parameters (before surgery, on postoperative day 1 and day 7), operative time, blood loss, and complications were compared between the two groups. Results No statistically significant differences were found in baseline characteristics between the two groups (P>0.05). Before surgery, there were no significant differences in total bilirubin, alanine aminotransferase, aspartate aminotransferase, and albumin levels between the two groups (P>0.05); on postoperative day 7, albumin levels also showed no significant difference (P>0.05). Compared with patients in the planning-only group, patients in the multimodal navigation group had significantly lower levels of total bilirubin, alanine aminotransferase, and aspartate aminotransferase on postoperative day 1 and day 7, and significantly higher albumin level on postoperative day 1 (P<0.05). Patients in the multimodal navigation group also had significantly shorter operative time, duration of drain retention, and postoperative hospital stay, less intraoperative blood loss, and a lower rate of blood transfusion than those in the planning-only group (P<0.05). The overall postoperative complication rates were 13.2% in the multimodal navigation group and 31.8% in the planning-only group, with the multimodal navigation group showing a significantly lower rate (P<0.05). Conclusion Compared with laparoscopic hepatectomy guided by simulated surgical planning alone, simulated surgical planning combined with multimodal intraoperative navigation is a more effective treatment for primary liver cancer, which enables precise resection while better preserving hepatic function.