关键词: 肝锥形单位, 肝切除术, 腹腔镜, 荧光成像, 吲哚菁绿, 声诺维

Abstract: The application of ultrasound-guided percutaneous transhepatic injection of indocyanine green and sonovue mixture in laparoscopic liver cone-unit resection        CHENG Dong-hui, YANG Chong, JIANG Ji-peng,et al. Department of Hepatobiliary and Pancreatic Surgery, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, China
Corresponding author: ZHANG Yu ,E-mail: zhangyuqg@med.uestc.edu.cn
Abstract    Objective    To investigate the application value of ultrasound-guided percutaneous transhepatic injection of indocyanine green and sonovue mixture in laparoscopic liver cone-intersection. Methods    A total of 16 patients with hepatocellular carcinoma who were admitted to the Sichuan Provincial People's Hospital from January 2022 to May 2023 were retrospectively analyzed. All of them underwent ultrasound-guided percutaneous transhepatic injection of indocyanine green and sonovue mixture in laparoscopic liver cone-unit resection. Observation indicators include tumor fluorescence imaging, cone unit fluorescence staining, perioperative indicators of patients, and follow-up. Results    All 16 patients successfully displayed the tumor boundary using ICG fluorescence, and the liver cone-unit ICG fluorescence imaging included the tumor completely. Among them, 15 patients had a liver cone-unit fluorescence boundary that was more than 1cm away from the tumor boundary, and 1 patient was about 0.5cm. Postoperative anatomical specimens with a cutting edge of 0.5-1.6 cm. Among 16 patients, 3 patients underwent puncture of 2 portal veins, and 13 patients underwent puncture of 1 portal vein, similar to preoperative evaluation. The surgical duration ranges from 62 to 121 minutes, with a median duration of 89 minutes. Intraoperative bleeding was 30-110 mL, with a median bleeding volume of 80 mL. There was no intraoperative blood transfusion or conversion to open surgery. No patients had recurrence after operation, up to July 12, 2023, when the follow-up period ranged from 2 to 14 months. Conclusion Ultrasound-guided percutaneous transhepatic injection of a mixture of indocyanine green and sonovue-assisted laparoscopic liver cone-unit resection is safe and feasible. Its long-term effect on liver malignant tumors is worth further study.

Key words: liver cone-unit, hepatectomy, laparoscopy, fluorescence imaging, indocyanine green, sonovue