ArticleFrontiers in oncology2022
Trans-arterial positive ICG staining-guided laparoscopic liver watershed resection for hepatocellular carcinoma.
Article in Frontiers in oncology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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6 citing papers in PubMed, 10 citations in OpenAlex.
- Progress in the Design and Clinical Application of Probes for Fluorescence-Guided Laparoscopic Surgery.Chemical & biomedical imaging · 2026Review
- Clinical applications of indocyanine green fluorescence for the treatment of hepatocellular carcinoma.World journal of gastrointestinal oncology · 2026Review
- Application of laparoscopic intraoperative ultrasound in laparoscopic hepatic resection for liver tumor.World journal of gastrointestinal surgery · 2025Review
- Soft Robots with Cy5: An "Intake and Work" Imaging Technique for Intraoperative Navigation of Gastric Lesion.Cyborg and bionic systems (Washington, D.C.) · 2025Article
- Case report: How I do it? Laparoscopic hepatectomy with transcatheter arterial ICG staining for hepatolithiasis review.Frontiers in medicine · 2024Article
- Indocyanine green fluorescence in gastrointestinal surgery: Appraisal of current evidence.World journal of gastrointestinal surgery · 2023Review
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Authors and funding
11 authors at 3 institutions in 1 country.
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Abstract
Introduction: Anatomical liver resection is the optimal treatment for patients with resectable hepatocellular carcinoma (HCC). Laparoscopic Couinaud liver segment resection could be performed easily as liver segments could be stained by ultrasound-guided indocyanine green (ICG) injection into the corresponding segment portal vein. Several smaller liver anatomical units (liver watersheds) have been identified (such as S8v, S8d, S4a, and S4b). However, since portal veins of liver watersheds are too thin to be identified under ultrasound, the boundaries of these liver watersheds could not be stained intraoperatively, making laparoscopic resection of these liver watersheds demanding. Digital subtraction angiography (DSA) could identify arteries of liver watersheds with a diameter of less than 2 mm. Yet, its usage for liver watershed staining has not been explored so far. Purpose: The aim of this study is to explore the possibility of positive liver watershed staining Methods: We describe, in a step-by-step approach, the application of trans-arterial ICG injection to stain aimed liver watershed during laparoscopic anatomical hepatectomy. The efficiency and safety of the technique are illustrated and discussed in comparison with the laparoscopic anatomical liver resection Results: Eight of 10 HCC patients received successful trans-arterial liver watershed staining. The success rate of the trans-artery staining approach was 80%, higher than that of the ultrasound-guided portal vein staining approach (60%). Longer surgical duration was found in patients who underwent the trans-artery staining approach (305.3 ± 23.2 min vs. 268.4 ± 34.7 min in patients who underwent the ultrasound-guided portal vein staining approach, Conclusions: Trans-arterial ICG staining is safe and feasible for staining the aimed liver watershed, navigating watershed-oriented hepatic resection under fluorescence laparoscopy for surgeons.
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