Tan To Cheung. The University of Hong Kong
Introduction: In laparoscopic hepatectomy, the surgeon cannot use their hand to palpate the liver lesion and estimate margin of resection. The use of ICG immunofluorescence technique can show up the liver tumour and has the potential to facilitate a throughout assessment during the operation.
Method: Between 2013 and 2016, there were 182 patients undergone pure laparoscopic liver resection for HCC in our hospital. 162 patients had undergone surgery by the conventional laparoscopic approach. 20 patients had laparoscopic hepatectomy with additional ICG immunofluorescence augmented technique.
The surgical outcome was compared with propensity score analysis in a ratio of 1:3.
Result: 20 patients had ICG immunofluorescence assisted laparoscopic hepatectomy (Group 1). 60 patients using conventional laparoscopic liver resection with propensity-matched were selected for comparison. (Group 2). The median operation time was 200 minutes vs 164 minutes p=0.679, the median blood loss was 125ml vs 100ml (p=0.928). 3 additional tumours were identified by ICG technique. 3 patients had suspicious lesion picked up by ICG technique but proven to be benign pathology on frozen section examination. The sensitivity of tumour detection by group 1 was 90%. 100% R0 resection was achieved in Group 1 and Group 2 respectively.
Hospital stay was 5 days vs 4 days (p=0.824), post-operative complication was 0(0%) vs 5(8.3%) (p=0.424) None of the patient developed ICG related complication.
Conclusion: In the current study, the new technique showed equally good short-term outcome when compared with conventional laparoscopic hepatectomy. ICG immunofluorescence augmented reality is a promising technique that might facilitate easier identification tumour during laparoscopic hepatectomy.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 88598
Program Number: P539
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster