Resection of Hepatic Lesions Perfused by the Cholecystic Vein Using Indocyanine Green Navigation in Patients with cT2 Gallbladder Cancer

Naokazu Chiba, Motohide Shimazu, Shigeto Ochiai, Kei Yokozuka, Takahiro Gunji, Masaaki Okihara, Toru Sano, Koichi Tomita, Rina Tsutsui, Go Oshima, Kiminori Takano, Yuta Abe, Hiroshi Hirano, Shigeyuki Kawachi

Research output: Contribution to journalArticle

Abstract

Background: Various approaches to hepatectomy have been proposed for cT2 gallbladder cancers (GBC), but the optimal management strategy remains unclear. The aim of this study is to assess the effectiveness of using an indocyanine green (ICG)-based intraoperative navigation system during hepatic resection for cT2 GBC. Methods: From September 2007 to December 2017, 24 consecutive patients diagnosed with cT2 GBC underwent hepatic resection using ICG navigation. After cannulation of the cholecystic artery, ICG diluted with dissolution liquid was injected and ICG fluorescence illumination was visualized with the HyperEye Medical System. And additional histopathological examination was performed on the most recent 15 of the 24 patients for detection of microscopic liver metastasis. Results: For all patients, the disease-free survival rate was 59.1% at 5 years and overall survival rate was 86.2% at 5 years. Microscopic liver metastasis was detected in the resected liver in 3 (20%) of 15 patients, whose site of liver was S6, S5, and S5, respectively. The weight of the liver resected using ICG navigation was significantly smaller than that of S4a/S5 segmentectomy (P < 0.0001). Conclusion: Resected hepatic lesion using ICG imaging was possible to perform hepatectomy including liver micro-metastasis without excess or deficiency. This procedure might be novel intraoperative imaging method to provide valuable information on the optimal surgical approach to cT2 GBC.

Original languageEnglish
JournalWorld Journal of Surgery
DOIs
Publication statusAccepted/In press - 2018 Jan 1

Fingerprint

Patient Navigation
Gallbladder Neoplasms
Indocyanine Green
Gallbladder
Veins
Liver
Hepatectomy
Neoplasm Metastasis
Survival Rate
S 6
Segmental Mastectomy
Lighting
Catheterization
Disease-Free Survival
Arteries
Fluorescence

ASJC Scopus subject areas

  • Surgery

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Resection of Hepatic Lesions Perfused by the Cholecystic Vein Using Indocyanine Green Navigation in Patients with cT2 Gallbladder Cancer. / Chiba, Naokazu; Shimazu, Motohide; Ochiai, Shigeto; Yokozuka, Kei; Gunji, Takahiro; Okihara, Masaaki; Sano, Toru; Tomita, Koichi; Tsutsui, Rina; Oshima, Go; Takano, Kiminori; Abe, Yuta; Hirano, Hiroshi; Kawachi, Shigeyuki.

In: World Journal of Surgery, 01.01.2018.

Research output: Contribution to journalArticle

Chiba, Naokazu ; Shimazu, Motohide ; Ochiai, Shigeto ; Yokozuka, Kei ; Gunji, Takahiro ; Okihara, Masaaki ; Sano, Toru ; Tomita, Koichi ; Tsutsui, Rina ; Oshima, Go ; Takano, Kiminori ; Abe, Yuta ; Hirano, Hiroshi ; Kawachi, Shigeyuki. / Resection of Hepatic Lesions Perfused by the Cholecystic Vein Using Indocyanine Green Navigation in Patients with cT2 Gallbladder Cancer. In: World Journal of Surgery. 2018.
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abstract = "Background: Various approaches to hepatectomy have been proposed for cT2 gallbladder cancers (GBC), but the optimal management strategy remains unclear. The aim of this study is to assess the effectiveness of using an indocyanine green (ICG)-based intraoperative navigation system during hepatic resection for cT2 GBC. Methods: From September 2007 to December 2017, 24 consecutive patients diagnosed with cT2 GBC underwent hepatic resection using ICG navigation. After cannulation of the cholecystic artery, ICG diluted with dissolution liquid was injected and ICG fluorescence illumination was visualized with the HyperEye Medical System. And additional histopathological examination was performed on the most recent 15 of the 24 patients for detection of microscopic liver metastasis. Results: For all patients, the disease-free survival rate was 59.1{\%} at 5 years and overall survival rate was 86.2{\%} at 5 years. Microscopic liver metastasis was detected in the resected liver in 3 (20{\%}) of 15 patients, whose site of liver was S6, S5, and S5, respectively. The weight of the liver resected using ICG navigation was significantly smaller than that of S4a/S5 segmentectomy (P < 0.0001). Conclusion: Resected hepatic lesion using ICG imaging was possible to perform hepatectomy including liver micro-metastasis without excess or deficiency. This procedure might be novel intraoperative imaging method to provide valuable information on the optimal surgical approach to cT2 GBC.",
author = "Naokazu Chiba and Motohide Shimazu and Shigeto Ochiai and Kei Yokozuka and Takahiro Gunji and Masaaki Okihara and Toru Sano and Koichi Tomita and Rina Tsutsui and Go Oshima and Kiminori Takano and Yuta Abe and Hiroshi Hirano and Shigeyuki Kawachi",
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T1 - Resection of Hepatic Lesions Perfused by the Cholecystic Vein Using Indocyanine Green Navigation in Patients with cT2 Gallbladder Cancer

AU - Chiba, Naokazu

AU - Shimazu, Motohide

AU - Ochiai, Shigeto

AU - Yokozuka, Kei

AU - Gunji, Takahiro

AU - Okihara, Masaaki

AU - Sano, Toru

AU - Tomita, Koichi

AU - Tsutsui, Rina

AU - Oshima, Go

AU - Takano, Kiminori

AU - Abe, Yuta

AU - Hirano, Hiroshi

AU - Kawachi, Shigeyuki

PY - 2018/1/1

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N2 - Background: Various approaches to hepatectomy have been proposed for cT2 gallbladder cancers (GBC), but the optimal management strategy remains unclear. The aim of this study is to assess the effectiveness of using an indocyanine green (ICG)-based intraoperative navigation system during hepatic resection for cT2 GBC. Methods: From September 2007 to December 2017, 24 consecutive patients diagnosed with cT2 GBC underwent hepatic resection using ICG navigation. After cannulation of the cholecystic artery, ICG diluted with dissolution liquid was injected and ICG fluorescence illumination was visualized with the HyperEye Medical System. And additional histopathological examination was performed on the most recent 15 of the 24 patients for detection of microscopic liver metastasis. Results: For all patients, the disease-free survival rate was 59.1% at 5 years and overall survival rate was 86.2% at 5 years. Microscopic liver metastasis was detected in the resected liver in 3 (20%) of 15 patients, whose site of liver was S6, S5, and S5, respectively. The weight of the liver resected using ICG navigation was significantly smaller than that of S4a/S5 segmentectomy (P < 0.0001). Conclusion: Resected hepatic lesion using ICG imaging was possible to perform hepatectomy including liver micro-metastasis without excess or deficiency. This procedure might be novel intraoperative imaging method to provide valuable information on the optimal surgical approach to cT2 GBC.

AB - Background: Various approaches to hepatectomy have been proposed for cT2 gallbladder cancers (GBC), but the optimal management strategy remains unclear. The aim of this study is to assess the effectiveness of using an indocyanine green (ICG)-based intraoperative navigation system during hepatic resection for cT2 GBC. Methods: From September 2007 to December 2017, 24 consecutive patients diagnosed with cT2 GBC underwent hepatic resection using ICG navigation. After cannulation of the cholecystic artery, ICG diluted with dissolution liquid was injected and ICG fluorescence illumination was visualized with the HyperEye Medical System. And additional histopathological examination was performed on the most recent 15 of the 24 patients for detection of microscopic liver metastasis. Results: For all patients, the disease-free survival rate was 59.1% at 5 years and overall survival rate was 86.2% at 5 years. Microscopic liver metastasis was detected in the resected liver in 3 (20%) of 15 patients, whose site of liver was S6, S5, and S5, respectively. The weight of the liver resected using ICG navigation was significantly smaller than that of S4a/S5 segmentectomy (P < 0.0001). Conclusion: Resected hepatic lesion using ICG imaging was possible to perform hepatectomy including liver micro-metastasis without excess or deficiency. This procedure might be novel intraoperative imaging method to provide valuable information on the optimal surgical approach to cT2 GBC.

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