Laparoscopic Anatomic Segmentectomy of Segments VIII and IVa with Middle Hepatic Vein Excision Using Ultrasound-Guided ICG Positive Staining.
Jinxing Wei, Wenliang Tan, Yajin Chen et al.
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From the abstract
Anatomic liver resection traditionally relies on intraoperative ultrasound to identify hepatic veins as landmarks for parenchymal transection. 1-3 Recently, portal territory staining with indocyanine green (ICG) has emerged as a key research focus in precision liver surgery, offering direct visualization of segmentation boundaries.
Reported results
The total operative time was 240 min, with the staining procedure requiring 30 min. Intraoperative blood loss was 50 mL. The fluorescent boundaries closely correlated with the subsequent ischemic planes after targeted pedicle division. Histopathology confirmed HCC with microvascular invasion and satisfied margins.
Authors' conclusions
The "jigsaw-patterned" multi-subsegmental portal vein ICG staining technique is technically feasible and safe. It enables precise anatomic resection for complex HCC spanning multiple segments, optimizing oncologic margin control while sparing functional parenchyma.