The Application Of Indocyan Green Fluorescence Staining Combined With Intraoperative Ultrasound In Laparoscopic Hepatocellular Carcinoma Resection

Objective:To compare and analyze the difference of efficacy between intraoperative laparoscopic hepatectomy with indocyangreen fluorescence staining combined with intraoperative ultrasound and conventional high-resolution laparoscopic hepatectomy for hepatocellular carcinoma,and to investigate the value of indocyanine green fluorescence staining combined with intraoperative ultrasound in laparoscopic hepatocellular carcinoma resection.Methods:The data of patients who underwent hepatocellular carcinoma resection in the Department of Hepatobiliary Surgery of the People’s Hospital Affiliated to Nanchang University and the First Affiliated Hospital of Nanchang University from January2017 to June 2020 were retrospectively analyzed.They were divided into fluorescence group and non-fluorescence group,in which the fluorescence group(n=15)was treated with indocyan green fluorescence staining combined with intraoperative ultrasound for laparoscopic liver tumor resection,and the non-fluorescence group(n=30)was treated with routine high-resolution laparoscopic liver tumor resection.The operative time,intraoperative blood loss,hilar occlusion time,postoperative hospitalization time,postoperative complication rate,postoperative ventilation time,postoperative mean drainage tube extubation time,positive rate of surgical margin,postoperative pathology and tumor recurrence rate were compared between the two groups.Results:The surgical plan was successfully implemented in all 45 patients,and none of them were converted to laparotomy.There is no significant difference in general data between the two groups(P>0.05),which is comparable.There were significant differences in intraoperative blood loss(214.60±57.79 ml vs 236.20±98.41ml)and hepatic portal occlusion time(43.80±5.58 min vs 49.17±8.52min)between fluorescent group and non-fluorescent group(P<0.05).Operation time(232.80±33.24 min vs281.96±31.83min),intraoperative blood transfusion rate(13.3% vs 23.3%),postoperative ventilation time(3.46±0.51 d vs 3.83±0.74d),and average extubation time(5.93±0.67 d vs 6.26±1.08d).There was no significant difference in postoperative hospital stay(11.06±1.38 d vs 11.36±1.86 d d),postoperative pathology,surgical complications and tumor recurrence rate(P>0.05).Conclusion:1.Both groups of operations are feasible and safe for the treatment of liver cancer patients,and good therapeutic effects can be achieved in the treatment of liver tumor patients.2.Compared with conventional high-definition laparoscopic surgery,indocyan green fluorescence staining combined with intraoperative ultrasound for laparoscopic liver tumor resection has more advantages in reducing intraoperative blood loss and shorting the time of portal occlusion.3.Laparoscopic liver tumor resection by indocyan green fluorescence staining combined with intraoperative ultrasound can obtain more accurate liver resection margin,reduce postoperative complications such as bile leakage and surgical bleeding,and improve the prognosis of patients.