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Concomitant Use of Indocyanine Green Fluorescence Imaging and Interventional Radiology for Detection of Liver Segments During Laparoscopic Anatomical Liver Resection

Pilot Feasibility Study

Ueno, Masaki MD, PhD*; Hayami, Shinya MD, PhD*; Sonomura, Tetsuo MD, PhD; Kawai, Manabu MD, PhD*; Hirono, Seiko MD, PhD*; Okada, Ken-ichi MD, PhD*; Tanaka, Ryota MD; Yamaue, Hiroki MD, PhD*

Surgical Laparoscopy Endoscopy & Percutaneous Techniques: August 2019 - Volume 29 - Issue 4 - p 242–246
doi: 10.1097/SLE.0000000000000631
Original Articles

We investigate the feasibility of using indocyanine green (ICG) fluorescence imaging with interventional radiology (IVR) techniques for indication of liver segments during laparoscopic anatomical liver resection (LapAR). Ten patients with planned LapAR (segmentectomy V, VI, VII, or VIII) were enrolled. Both IVR and LapAR were performed in a hybrid operating room. Two dyes (indigo carmine and ICG) and embolic solutions were injected into the target liver segment. We compared imaging results during LapAR. ICG fluorescence imaging (ICGFI) provided clear visual contrast. Median contrast index value of ICGFI was 1.12, superior to that of indigo carmine (0.21; P=0.005). ICGFI was still visible during liver resection. Estimated liver resection volume and actual resected liver weight correlated significantly (R=0.906; P<0.01). ICGFI delivered by IVR provided clearer visual information than conventional indigo carmine dye, enabling precise performance of LapAR as planned (UMIN-CTR No. 000023952).

*Second Department of Surgery

Department of Radiology, Wakayama Medical University, Wakayama, Japan

The authors declare no conflicts of interest.

Reprints: Hiroki Yamaue, MD, PhD, Second Department of Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama 641-8510, Japan (e-mail:

Received October 17, 2018

Accepted December 10, 2018

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