ArticleSurgical endoscopy2025
Indocyanine green fluorescence imaging (ICG-FI) in difficult laparoscopic hepatectomy for hepatocellular carcinoma: a retrospective propensity score-matched analysis.
Article in Surgical endoscopy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed.
- Preliminary Application of TROP2-Targeted Peptide Screening for Real-Time Intraoperative Navigation in Pancreatic Cancer.Chemical & biomedical imaging · 2026Article
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6 authors.
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Abstract
backgroundIndocyanine green fluorescence imaging (ICG-FI) is increasingly used in laparoscopic hepatectomy (LH). However, its efficacy in enhancing both short- and long-term outcomes in difficult LH for hepatocellular carcinoma (HCC) compared with traditional white light (WL) LH remains unclear.
methodsThis retrospective cohort study analyzed 573 patients who underwent LH between April 2018 and April 2023, stratified by the use of ICG-FI or WL. Propensity score matching (PSM, 1:1) was employed to minimize baseline discrepancies and reduce selection bias. Perioperative outcomes, overall survival (OS), and recurrence-free survival (RFS) were evaluated. Kaplan-Meier survival analysis was conducted to compare OS and RFS between groups, and Cox regression models were applied to identify independent prognostic factors.
resultsAmong the 573 patients who underwent LH, 178 were classified as high-difficulty hepatectomies, including 47 patients in the ICG-FI group and 131 in the WL group. After PSM, 78 patients were matched, with 39 patients in each group. In both unmatched and matched cohorts, the ICG-FI group demonstrated significantly lower conversion rates (2.6% vs. 15.4%, P = 0.048), shorter durations of drainage tube placement (7.0 [5.0, 8.0] vs. 7.0 [6.0, 9.5], P = 0.048), fewer severe postoperative complications (2.6% vs. 15.4%, P = 0.048), and reduced postoperative hospital stays (7 [4.5, 9] vs. 8 [7, 10], P = 0.045). Kaplan-Meier analysis revealed significantly improved RFS in the ICG-FI group compared with the WL group (P = 0.021). Independent predictors of RFS included ICG-FI, liver cirrhosis, and the presence of satellite nodules. Independent predictors of OS included LH performed at the expert difficulty level (HR = 2.875, 95% CI: 1.331-6.207, P = 0.007) and R0 resection (HR = 0.142, 95% CI: 0.028-0.734, P = 0.020).
conclusionsICG-FI demonstrates significant benefits in short-term outcomes and enhances RFS in patients undergoing difficult LH for HCC. However, its impact on OS warrants further validation through large-scale, multicenter prospective studies.
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