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.
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.
['Zhai|Shu-Ting|ST|http://orcid.org/0000-0001-6569-0637', 'Liang|Xiao|X|', 'Mao|Qi-Jiang|QJ|', 'Liang|Yue-Long|YL|', 'Xu|Jun-Jie|JJ|', 'Chen|Jiang|J|', 'Shi|Liang|L|', 'Xie|Yang-Yang|YY|', 'Cai|Xiu-Jun|XJ|']
D000368:Aged D000369:Aged, 80 and over D001650:Bile Duct Neoplasms D018281:Cholangiocarcinoma D004396:Coloring Agents D005240:Feasibility Studies D005260:Female D006801:Humans D007208:Indocyanine Green D007432:Intraoperative Period D010535:Laparoscopy D008297:Male D008875:Middle Aged D061848:Optical Imaging D010865:Pilot Projects D011300:Preoperative Care D012189:Retrospective Studies D013194:Staining and Labeling
intrahepatic cholangiocarcinoma indocyanine green fluorescence imaging laparoscopic anatomical hepatectomies