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Updated: Jan 15, 2026
Laparoscopic Anatomical Hepatectomy Using Takasaki's Approach and Indocyanine Green Fluorescence Navigation
Published on: May 16, 2025
Indocyanine green fluorescence navigation versus conventional laparoscopic hepatectomy for hepatic hemangioma: a
Zhang-Neng Yu1, Lian Li1,2, Liang Wang1
1Division of Liver Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China.
Background:
Indocyanine Green (ICG) fluorescence navigation is increasingly used in laparoscopic liver surgeries, yet its benefits for hepatic hemangioma resection remain unclear. This study assessed the effectiveness and clinical value of ICG fluorescence navigation laparoscopic hepatectomy for hepatic hemangioma, compared with the conventional laparoscopic resection.
Methods:
We retrospectively analyzed a cohort of hepatic hemangioma patients who underwent laparoscopic hepatectomy at West China Hospital of Sichuan University from May 2015 to April 2024. Propensity score matching (PSM) was utilized to match patients undergoing ICG fluorescence navigation laparoscopic hepatectomy (ICG-LH) with those undergoing conventional laparoscopic hepatectomy (LH) in a 1:3 ratio to minimize the influence of confounding factors. We compared perioperative variables between the two groups to ascertain the superior method for hepatic hemangioma hepatectomy.
Results:
ICG-LH demonstrated superior perioperative outcomes (median blood loss: 100 ml vs 200 ml, p < 0.001; hospitalization: 5.9 days vs 7.1 days, p < 0.001). Albumin levels on postoperative day 1 and day 3 were found to be significantly higher in the ICG-LH compared to the LH group (p < 0.05). Subgroup analyses based on IWATE criteria revealed that, in patients with an IWATE score greater than 9, compared to the LH group patients, ICG-LH patients exhibited shorter operative time (158.3 min vs 224.4 min, p < 0.001), significantly reduced blood loss (100 ml vs 500 ml, p = 0.001), decreased number of hepatic inflow occlusions (1.5 times vs 3 times, p = 0.002), and a reduction in the total duration of hepatic inflow occlusion (35 min vs 55 min, p = 0.004).
Conclusions:
The comparative analysis revealed the advantages of ICG-LH over conventional LH approaches for hepatic hemangioma resection, demonstrating its enhanced perioperative performance metrics, and may potentially optimize postoperative functional recovery while reducing procedure-related morbidity.
