Laparoscopic observation of liver colored with indocyanine green in chronic hepatitis. II. Correlation with subcapsular ligandin.

Intravenous injection of indocyanine green improves the laparoscopic diagnosis of liver disease. To clarify the basis for the laparoscopic appearance of indocyanine green-colored liver, local indocyanine green coloration was compared with the hepatic ligandin in the corresponding subcapsular tissue. Two liver biopsy specimens were obtained from each of 13 patients with chronic hepatitis, and the ligandin was stained by an immunohistochemical method. In cases showing homogeneous indocyanine green coloration, the ligandin in the two biopsy specimens was similarly stained. On the other hand, in cases showing inhomogeneous coloration of indocyanine green, biopsy specimens from the well-colored area showed focal regeneration and were rich in ligandin, whereas biopsy specimens from less-colored lesions showed fibrosis, necrosis, or severe inflammation, and the ligandin was poorly stained. These results suggest that the characteristic laparoscopic appearance of the indocyanine green-colored liver reflects the changes of intrahepatic ligandin distribution associated with pathologic changes in the liver of patients with chronic hepatitis.