Majlesara Ali, Golriz Mohammad, Hafezi Mohammadreza, Saffari Arash, Stenau Esther, Maier-Hein Lena, Müller-Stich Beat P, Mehrabi Arianeb
Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany.
Division of Computer-assisted medical interventions, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Photodiagnosis Photodyn Ther. 2017 Mar;17:208-215. doi: 10.1016/j.pdpdt.2016.12.005. Epub 2016 Dec 23.
Indocyanine green (ICG) is a fluorescent dye that has been widely used for fluorescence imaging during hepatobiliary surgery. ICG is injected intravenously, selectively taken up by the liver, and then secreted into the bile. The catabolism and fluorescence properties of ICG permit a wide range of visualization methods in hepatobiliary surgery. We have characterized the applications of ICG during hepatobiliary surgery into: 1) liver mapping, 2) cholangiography, 3) tumor visualization, and 4) partial liver graft evaluation. In this literature review, we summarize the current understanding of ICG use during hepatobiliary surgery. Intra-operative ICG fluorescence imaging is a safe, simple, and feasible method that improves the visualization of hepatobiliary anatomy and liver tumors. Intravenous administration of ICG is not toxic and avoids the drawbacks of conventional imaging. In addition, it reduces post-operative complications without any known side effects. ICG fluorescence imaging provides a safe and reliable contrast for extra-hepatic cholangiography when detecting intra-hepatic bile leakage following liver resection. In addition, liver tumors can be visualized and well-differentiated hepatocellular carcinoma tumors can be accurately identified. Moreover, vascular reconstruction and outflow can be evaluated following partial liver transplantation. However, since tissue penetration is limited to 5-10mm, deeper tissue cannot be visualized using this method. Many instances of false positive or negative results have been reported, therefore further characterization is required.
吲哚菁绿（ICG）是一种荧光染料，已广泛用于肝胆手术中的荧光成像。ICG通过静脉注射，被肝脏选择性摄取，然后分泌到胆汁中。ICG的分解代谢和荧光特性使得在肝胆手术中有多种可视化方法。我们将ICG在肝胆手术中的应用分为：1）肝图谱绘制，2）胆管造影，3）肿瘤可视化，4）部分肝移植评估。在这篇文献综述中，我们总结了目前对ICG在肝胆手术中应用的认识。术中ICG荧光成像为一种安全、简单且可行的方法，可改善肝胆解剖结构和肝肿瘤的可视化。静脉注射ICG无毒，避免了传统成像的缺点。此外，它可减少术后并发症且无任何已知副作用。在检测肝切除术后肝内胆汁漏时，ICG荧光成像为肝外胆管造影提供了安全可靠的对比。此外，可实现肝肿瘤可视化，且能准确识别高分化肝细胞癌肿瘤。此外，在部分肝移植后可评估血管重建和血流情况。然而，由于组织穿透深度限制在5-10毫米，该方法无法可视化更深层的组织。已报道了许多假阳性或假阴性结果的情况，因此需要进一步研究。
