{
  "abstract": "INTRODUCTION:: Anatomical hepatectomy improves outcomes in hepatocellular carcinoma (HCC), but remains technically demanding laparoscopically. Indocyanine green (ICG) fluorescence may aid navigation, yet its clinical value remains unproven.\n\nAIM:: We aimed to evaluate whether ICG-guided laparoscopic anatomical hepatectomy improved resection quality and short-term outcomes, as compared with conventional high-definition laparoscopy.\n\nMATERIALS AND METHODS:: In this single-center, prospective, open-label, parallel-group randomized controlled trial (October 2023–December 2025), 100 patients with resectable primary HCC were randomized at a 1:1 ratio to the ICG-guided laparoscopic anatomical hepatectomy (n = 50) or conventional laparoscopy (n = 50) cohorts. The ICG protocol included preoperative intravenous ICG plus intraoperative ultrasound-guided positive / negative staining. Primary outcomes were anatomical resection and R0 rates. Secondary outcomes included blood loss, complications, 1-year disease-free survival (DFS), and overall survival (OS).\n\nRESULTS:: Baseline characteristics of the study population were balanced. Tumor fluorescence and segmental staining were successful in 94% and 98% of the ICG patients, respectively. The ICG group achieved higher anatomical resection (94% vs 58%; P <0.001) and R0 rates (100% vs 86%; P = 0.01), wider margins (mean [SD], 10.27 [3.39] vs 6.97 [4.11] mm; P <0.001), less mean blood loss (217.2 [88.76] vs 298.44 [156.19] ml; P = 0.002), fewer complications (18% vs 50%; P <0.001), and shorter hospital stay (mean, 7.65 [1.68] vs 8.93 [2.84] d; P = 0.008) than the controls. ICG detected additional lesions in 20% of the patients. One-year DFS (88% vs 75.04%) and OS (93.82% vs 91.49%; P = 0.8) were similar in both groups. Adjusted recurrence hazard ratio was 2.146 (95% CI, 0.932–4.938; P = 0.07).\n\nCONCLUSIONS:: ICG fluorescence-guided laparoscopic anatomical hepatectomy is safe and feasible, significantly improving radical resection quality with more anatomical dissections, higher R0 rates, wider margins, and fewer complications, as compared with the conventional approach. Longer follow-up is needed to confirm survival benefits.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Hepatopancreatobiliary Surgery, Ganzhou People’s Hospital, Ganzhou, Jiangxi Province, China",
    "Department of General Surgery, Wanan County People’s Hospital, Ji’an, Jiangxi Province, China"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 7,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Yong He"
    },
    {
      "affs": [
        1
      ],
      "name": "Yao Xiao"
    },
    {
      "affs": [
        0
      ],
      "name": "Yuancai Xie"
    },
    {
      "affs": [
        0
      ],
      "name": "Xiaohong Deng"
    },
    {
      "affs": [
        0
      ],
      "name": "Yonghui Liao"
    },
    {
      "affs": [
        0
      ],
      "name": "Wenhui Chen"
    },
    {
      "affs": [
        0
      ],
      "name": "Long Zhang"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/bb7p6hy03t93c.bib",
  "cited_by": 0,
  "doi": "10.20452/wiitm.2026.18047",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13738039/",
  "id": "bb7p6hy03t93c",
  "issns": [
    "1895-4588",
    "2299-0054"
  ],
  "landing_url": "https://doi.org/10.20452/wiitm.2026.18047",
  "language": "en",
  "licence": "CC-BY-NC-SA-4.0",
  "licence_label": "CC BY-NC-SA 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-sa/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "General Surgery"
    ],
    [
      "openalex",
      "2721|Hepatocellular Carcinoma Treatment and Prognosis"
    ]
  ],
  "openalex": "W7223994084",
  "pdf_url": "https://www.mp.pl/videosurgery/en/node/18047/pdf",
  "pmcid": "PMC13738039",
  "pmid": "42992111",
  "published": "2026-10-19",
  "publisher": "Fundacja Wideochirurgii",
  "ris": "https://research.draconitic.com/paper/bb7p6hy03t93c.ris",
  "sources": [
    {
      "first_seen": "2026-11-09T12:23:06Z",
      "native_id": "PMC13738039",
      "source": "pmc",
      "url": "https://doi.org/10.20452/wiitm.2026.18047"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "journal-openalex:2746|Minimally Invasive Surgical Techniques",
      "subfield": "surgery"
    }
  ],
  "title": "Indocyanine green fluorescence–guided laparoscopic anatomical hepatectomy for radical resection of hepatocellular carcinoma: a clinical study",
  "title_text": "Indocyanine green fluorescence–guided laparoscopic anatomical hepatectomy for radical resection of hepatocellular carcinoma: a clinical study",
  "type": "peer-reviewed",
  "updated_at": "2026-11-09T12:23:06Z",
  "url": "https://research.draconitic.com/paper/bb7p6hy03t93c",
  "venue": "Videosurgery and other Miniinvasive Techniques",
  "versions": []
}