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Updated: Feb 17, 2026
Laparoscopic Anatomical Hepatectomy Using Takasaki's Approach and Indocyanine Green Fluorescence Navigation
Published on: May 16, 2025
Negative ICG fluorescence-guided laparoscopic right posterior liver resection for hepatocellular carcinoma improves
Chengxu Du1, Dongrui Li1, Xinda Yang1
1Department of Hepatobiliary Surgery, Second Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, China.
Objective:
To investigate the safety and efficacy of laparoscopic anatomic liver resection using indocyanine green (ICG) fluorescence imaging for the treatment of hepatocellular carcinoma located in the right posterior region.
Methods:
The clinical data of 75 patients who received laparoscopic right posterior liver resection by the same chief surgeon at the Second Hospital of Hebei Medical University, from January 2022 to May 2023, was analysed retrospectively. Patients were divided into two groups based on the use of ICG fluorescence imaging during surgery by 1:2 propensity score matching between patients of the ICG group (20 cases) and the non-ICG group (40 cases). The following indicators were compared between the two groups: (1) Preoperative general data; (2) Intraoperative surgical time, blood loss, hepatic portal occlusion time, and hemostasis time on the cut surface; and (3) Postoperative R0 resection rate, hospitalization time, abdominal drainage time, main liver function indicators, complications, and tumor recurrence at 1, 3, 6, 12, 18, 24 months postoperatively.
Results:
The operation time, hepatic portal occlusion time, and hemostasis time on the raw surface were statistically shorter in the ICG group compared to the non-ICG group (P < 0.05). The intraoperative blood loss was significantly less in the ICG group compared to the non-ICG group (P < 0.05). Additionally, there were statistically significances of the recovery and indicator levels of ALT and AST on postoperative days 1 between the ICG group and those in the non-ICG group (P < 0.05). However, there were no statistically significant differences were recorded in preoperative general data, postoperative total bilirubin level, postoperative complications, or tumor recurrence rates (P > 0.05). Moreover, no significant differences were detected in recurrence rates between the two groups at 1, 3, 6, 12, 18 and 24 months postoperatively (P > 0.05).
Conclusion:
The application of ICG fluorescence imaging may safely improve the surgical efficiency for laparoscopic right posterior liver resection.
