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A retrospective pilot study to examine the feasibility of real‐time navigation for laparoscopic liver resections in intrahepatic cholangiocarcinoma using fusion indocyanine green fluorescence imaging
Author(s) -
Zhai ShuTing,
Liang Xiao,
Mao QiJiang,
Liang YueLong,
Xu JunJie,
Chen Jiang,
Shi Liang,
Xie YangYang,
Cai XiuJun
Publication year - 2020
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.25940
Subject(s) - indocyanine green , medicine , intrahepatic cholangiocarcinoma , laparoscopy , resection , radiology , fluorescence lifetime imaging microscopy , nuclear medicine , surgery , fluorescence , pathology , physics , quantum mechanics
Background and Objectives Recently, PINPOINT, a novel laparoscopic fusion indocyanine green fluorescence imaging (IGFI) system has become available for laparoscopic liver resection. This study aims to characterize fluorescence patterns of intrahepatic cholangiocarcinoma (ICC) using the negative counterstaining method in laparoscopic anatomical hepatectomies of ICC. Methods Eleven consecutive patients, diagnosed with intrahepatic cholangiocarcinoma and underwent laparoscopic liver resection between April 2017 and December 2018, were retrospectively reviewed. A laparoscopic IGFI navigation system was used to characterize fluorescence patterns of ICC with intraoperative liver segment demarcation by means of negative counterstaining. Results Fusion IGFI of ICC was successfully obtained from all 11 patients from the surgical specimens. The fluorescence patterns of ICC can be categorized into rim‐type fluorescence and segmental fluorescence, depending on tumor growth. In eight patients, indocyanine green fluorescence imaging was used to identify the hepatic lobes or segments by negative counterstaining. In six cases, a valid and persistent demarcation was achieved intraoperatively. Conclusion Laparoscopic IGFI system could identify different types of ICC lesions and may facilitate real‐time navigation for laparoscopic anatomic liver resection of ICC.