Wang XR, Li XJ, Wan DD, Zhang Q, Liu TX, Shen ZW, Tong HX, Li Y, Li JW. Laparoscopic left hemihepatectomy guided by indocyanine green fluorescence: A cranial-dorsal approach. World J Gastrointest Surg 2024; 16(2): 409-418 [PMID: 38463374 DOI: 10.4240/wjgs.v16.i2.409]
Corresponding Author of This Article
Jian-Wei Li, PhD, Additional Professor, Institute of Hepatobiliary Surgery, First Affiliated Hospital, Army Medical University, No. 30 Gaotan Yanzheng Street, Shapingba District, Chongqing 400038, China. 594457357@qq.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
Share the Article
Wang XR, Li XJ, Wan DD, Zhang Q, Liu TX, Shen ZW, Tong HX, Li Y, Li JW. Laparoscopic left hemihepatectomy guided by indocyanine green fluorescence: A cranial-dorsal approach. World J Gastrointest Surg 2024; 16(2): 409-418 [PMID: 38463374 DOI: 10.4240/wjgs.v16.i2.409]
World J Gastrointest Surg. Feb 27, 2024; 16(2): 409-418 Published online Feb 27, 2024. doi: 10.4240/wjgs.v16.i2.409
Laparoscopic left hemihepatectomy guided by indocyanine green fluorescence: A cranial-dorsal approach
Xing-Ru Wang, Xiao-Ju Li, Dan-Dan Wan, Qian Zhang, Tian-Xi Liu, Zong-Wen Shen, Hong-Xing Tong, Yan Li, Jian-Wei Li
Xing-Ru Wang, Jian-Wei Li, Institute of Hepatobiliary Surgery, First Affiliated Hospital, Army Medical University, Chongqing 400038, China
Xiao-Ju Li, Qian Zhang, Tian-Xi Liu, Zong-Wen Shen, Hong-Xing Tong, Yan Li, Department of Hepatobiliary Surgery, Qujing Central Hospital of Yunnan Regional Medical Center, Qujing 655000, Yunnan Province, China
Dan-Dan Wan, School of Clinical Medicine, Qujing Medical College, Qujing 655000, Yunnan Province, China
Co-first authors: Xing-Ru Wang and Xiao-Ju Li.
Co-corresponding authors: Tian-Xi Liu and Jian-Wei Li.
Author contributions: Wang XR and Li XJ contributed equally to this work, reviewed and edited the manuscript; Wang XR and Li JW contributed to the conceptualization of the study; Wang XR contributed to the methodology, resources and funding acquisition, and is the project administration; Li XJ contributed to the software, formal analysis of the data, contributed to the data curation and drafted the manuscript; Wan DD contributed to the translation; Liu TX and Shen ZW contributed to the validation; Zhang Q contributed to the investigation; Shen ZW and Tong HX contributed to the visualization; Li JW supervised the study; all the authors have read and approved the final version.
Supported byThe High-level Talent Training Support Project of Yunnan Province, No. YNWR-MY-2020-053; and the Key Project of the Second People's Hospital of Qujing in 2022, No. 2022ynkt04.
Institutional review board statement: All methods were approved by the Research Medical Ethics Committee of Qujing Second People's Hospital and were performed in accordance with the approved guidelines (Ethical review: 2022-019-01).
Informed consent statement: All human tissue samples were collected by the Qujing Second People's Hospital and written informed consent was obtained from all patients.
Conflict-of-interest statement: The authors declare no conflicts of interest for this article.
Data sharing statement: The data supporting this article will be shared upon reasonable request to the corresponding author.
Corresponding author: Jian-Wei Li, PhD, Additional Professor, Institute of Hepatobiliary Surgery, First Affiliated Hospital, Army Medical University, No. 30 Gaotan Yanzheng Street, Shapingba District, Chongqing 400038, China. 594457357@qq.com
Received: September 13, 2023 Peer-review started: September 13, 2023 First decision: December 8, 2023 Revised: December 14, 2023 Accepted: January 24, 2024 Article in press: January 24, 2024 Published online: February 27, 2024 Processing time: 165 Days and 3.8 Hours
ARTICLE HIGHLIGHTS
Research background
The improved understanding of intrahepatic anatomy and rapid advances in laparoscopic technology have brought laparoscopic hepatectomy (LH) to the era of precise anatomical resection. Recently, the indocyanine green (ICG) fluorescence navigation technique has been applied in clinical practice and has emerged as the most effective method for identifying hepatic regions. Moreover, intraoperative ICG navigation might help overcome the limitations of LH.
Research motivation
This study investigated the effectiveness of standardized cranial-dorsal strategy for LLH with the aid of ICG fluorescence guidance.
Research objectives
The study aimed to investigate a standardized cranial-dorsal strategy for LLH, focusing on important anatomical markers, surgical skills, and ICG staining methods and the indicators of operation.
Research methods
A retrospective study design was employed, involving 37 patients who underwent ICG fluorescence-guided LLH. The cranial-dorsal approach was performed. Data on relevant indicators were collected preoperatively, intraoperatively, and postoperatively, and an analysis of surgical outcomes was conducted.
Research results
The comparison results showed that intraoperative blood loss during LLH was 335.68 ± 99.869 mL and the rates of transfusion and conversion to laparotomy were 13.5% and 0%, respectively. The overall incidence of complications throughout the follow-up was 21.6%. No severe complications or mortality were reported.
Research conclusions
The study findings demonstrate that LLH has the potential to become a novel, standardized approach that can effectively, safely, and simply expose the middle hepatic vein and meet the requirements of precision surgery.
Research perspectives
The results highlight the effectiveness of standardized cranial-dorsal strategy for LLH with the aid of ICG fluorescence guidance. The cranial-dorsal strategy has the potential to become a novel and standardized approach for LLH, and can effectively, safely, and simply expose the MHV to meet the requirements of precision surgery.
