The application of laparoscopy combined with indocyanine green fluorescence imaging technique for hepatic cystic echinococcosis

BMC Surgery

Yu-Peng Li¹  Yuan Meng¹  Zhi-De Li¹  Xiong Chen¹  Zhi-Gang Ma¹  Tuerhongjiang Tuxun² 

[1] Department of Hepatobiliary Surgery, People’s Hospital of Xinjiang Uygur Autonomous Region, No. 91 Tianchi Road, 830000, Urumqi, Xinjiang Uygur, China;Liver Transplantation & Laparoscopic Surgery Department/Digestive & Vascular Surgery Center, The First Affiliated Hospital, Xinjiang Medical University, 830054, Urumqi, Xinjiang Uygur, China;

关键词: Hepatic cystic echinococcosis;    Laparoscopy;    Pericystectomy;    Indocyanine green (ICG);    Fluorescence imaging;    Boundary;   

DOI  :  10.1186/s12893-020-00911-8

来源: Springer

【 摘 要 】

BackgroundWith the mature application of laparoscopy in hepatobiliary surgery, laparoscopic treatment of hepatic cystic echinococcosis (CE) has made certain progress. But, due to the inherent limitations of laparoscopy and the growth characteristics of cystic echinococcosis, distinguishing the boundary between cystic lesion and normal hepatic parenchyma is pivotal importance for successful surgery. Indocyanine green (ICG) fluorescence imaging technology can view the boundary of lesion and normal tissue during the treatment of hepatic cystic echinococcosis. Applied laparoscopy combined with ICG fluorescence imaging technique for hepatic cystic echinococcosis may be an effective surgical strategy.MethodsThe clinical data contained nine patients with hepatic cystic echinococcosis who underwent laparoscopic surgery with indocyanine green fluorescence imaging technique in authors’ institution from December 2018 to December 2019 were retrospectively analyzed. Indocyanine green was administered intravenously three days prior to surgery. The fluorescence acquisition system for real-time imaging was used during the surgery and the patients were followed up after surgery.ResultsOf reported nine patients, six are male and the remaining three are female. The average age is (36.4 ± 7.6) years. For all subjects, surgical procedures were performed under laparoscopy with indocyanine green fluorescence system. This technique showed the clear boundary of the hepatic cyst with normal liver parenchyma. Total cystectomy in six patients, subtotal cystectomy in two patients and partial hepatectomy in one patient were performed respectively. The average operation time was 3.8 ± 0.9 h, blood loss 206.0 ± 120.7 ml. Neither blood transfusion nor post-operative complication was experienced. The average abdominal drainage time was 3.4 ± 0.9 days with hospital stay 5.7 ± 2.1 days. During the 6–12 months follow-up period, neither recurrence nor intraperitoneal implantation was found.ConclusionsApplied laparoscopy combined with ICG fluorescence imaging technique for hepatic cystic echinococcosis is safe and feasible. Enhanced boundary image can assist surgeons to complete radical resection and reduce complications.

【 授权许可】

CC BY