Peritoneoscopy as an Aid in Intravenous Injection of Indocyanine Green (ICG)

Abstract

Peritoneoscopy as an aid in intravenous injection of indocyanine green (ICG) was clinically evaluated. Hepatic parenchyma was stained after intravenous injection of ICG, while interstitial connective tissue, fatty deposition and hepatoma tissue were not. Regenerative hepatic cell mass including dark reddish patchy marking (Shimada's code No. 7) and semispherical areas of regeneration or nodules (Shimada's code No. 8) was well stained and clearly contrasted. There were some cases of chronic active hepatitis, in which liver surface showed spotty staining at sites expected to become regenerative nodules in the future, in contrast to being judged as "no abnormal findings" peritoneoscopically. On the other hand, periportal reddish marking (Shimada's code No. 4) representing piecemeal or bridging hepatic cell necrosis was not stained.

Laparoscopic Findings in an Adult Case of Alagille Syndrome

“…The laparoscopic findings of our case showed a segmental whitish discoloration, which was not much stained by ICG, with a transverse sulcus. These findings confirm segmental necrosis and atrophy on the surface of the liver as normal hepatic parenchyma is homogeneously colored green after intravenous injection of ICG [3]. Sulcus formation may also be the result of segmental liver necrosis.…”

“…In particular, a transverse sulcus was seen on the discolored area of the left lobe. In addition, the area was not stained very much in contrast to other areas when indocyanine green (ICG) was intravenously administered at a dose of 4 mg/kg [3] (Figure 2).…”

Laparoscopic findings of reddish markings predict hepatocellular carcinoma in patients with hepatitis B virus-related liver disease

“…We selected the following six features for analysis, because these are routinely used for evaluation of disease progression and activity: surface irregularity, whitish markings, vascular proliferation, reddish markings, patchy markings, and fat deposition [18][19][20][21]. Surface irregularity was evaluated, based on depression and nodular formation, and classified into three stages: S1, normal or early stage; S2, advanced, pre-cirrhotic stage; and S3, cirrhotic stage.…”