Published online Mar 27, 2021. doi: 10.4240/wjgs.v13.i3.323
Peer-review started: November 4, 2020
First decision: November 25, 2020
Revised: December 9, 2020
Accepted: January 14, 2021
Article in press: January 14, 2021
Published online: March 27, 2021
Liver cancer is a malignant tumor with a high incidence. At present, the most effective treatment is laparoscopic hepatectomy (LH). Indocyanine green fluorescence imaging (ICG-FI) has become an important tool in LH, and the most common fluorescent types of tumors are total fluorescence, partial fluorescence, and rim fluorescence.
We presented four cases of LH guided by ICG-FI in which we also observed the fourth special fluorescent type. When the tumor or intrahepatic stone compresses the adjacent bile duct to cause local cholestasis, the liver segment or subsegment with obstructed bile drainage will show strong fluorescence. Complete removal of the lesion together with the fluorescent liver parenchyma may help reduce the risk of tumor or stone recurrence.
This type of partial fluorescence can indicate local biliary compression, and the resection method is related to bile drainage, which may be called functional anatomical hepatectomy and ensures radical resection of the lesion.
Core Tip: During laparoscopic hepatectomy guided by indocyanine green fluorescence imaging, tumor fluorescence usually manifests as total fluorescence, partial fluorescence, or rim fluorescence. However, surgeons occasionally encounter liver segment or subsegment fluorescence due to the tumor compressing the bile duct and local cholestasis. Despite malignant infiltration, stone compression and tumor thrombi in the bile duct can also cause this rare phenomenon. Complete removal of the lesions together with the fluorescent liver segment may help reduce the risk of tumor relapse, which can be called functional anatomical hepatectomy.