Institute of Hepatobiliary Surgery of the Army, Southwest Hospital, Army Medical University, Chongqing, China.
Chinese Minimally Invasive liver surgery Research Group (The Workshop of Liver Future [W.O.L.F]), Beijing, China.
Ann Surg Oncol. 2024 Oct;31(10):6546-6550. doi: 10.1245/s10434-024-15768-x. Epub 2024 Jul 12.
Because of the complex anatomy of the right posterior hepatic pedicle, there have been few reports on standardized laparoscopic portal territory staining-guided anatomical resection of liver segment 6 (LPTAR-S6). This study aimed to elucidate the indocyanine green (ICG) fluorescence staining methods for LPTAR-S6.
LPTAR-S6 can be performed using positive and negative fluorescence staining approaches. We implemented these two approaches for patients with hepatocellular carcinoma. Descriptions of the surgical strategy and technical details are presented.
Two patients safely underwent LPTAR-S6 using a preoperative three-dimensional reconstruction plan. The intraoperative ICG fluorescence staining effect was satisfactory, and the anatomical landmarks were fully exposed.
A detailed preoperative three-dimensional reconstruction plan, complete intraoperative application of real-time laparoscopic ultrasound guidance, and ICG fluorescence staining can result in accurate transection of the liver parenchyma during LPTAR-S6.
由于右后肝蒂的解剖结构复杂，关于标准化腹腔镜门脉区域染色引导肝段 6 解剖切除术（LPTAR-S6）的报道较少。本研究旨在阐明吲哚菁绿（ICG）荧光染色法在 LPTAR-S6 中的应用。
LPTAR-S6 可采用正染和负染两种方法进行。我们对患有肝细胞癌的患者实施了这两种方法。介绍了手术策略和技术细节。
两名患者均安全地通过术前三维重建计划实施了 LPTAR-S6。术中 ICG 荧光染色效果满意，解剖标志充分显露。
详细的术前三维重建计划、完整的术中实时腹腔镜超声引导以及 ICG 荧光染色可使 LPTAR-S6 中的肝实质准确离断。
