Preliminary results of fluorescent lymphography in patients with biliary cancer undergoing liver resection

作者：Polyakov AN, Korshak AV, Kotelnikov AG, Sagaidak IV, Kudashkin NE, Batalova MV, Umirzokov AS, Podluzhny DV · 发表于：Khirurgiia · 年份：2025 · DOI：10.17116/hirurgia202502127 · 研究领域：Lymphography、Hepatectomy、Sentinel Lymph Node、Lymph Nodes、Biliary Tract Neoplasms、Humans、Male、Female、Middle Aged、Aged、Indocyanine Green、Lymph Node Excision

OBJECTIVE: To evaluate the diagnostic capability of intraoperative fluorescence lymphography (FLG) in detecting of sentinel lymph nodes (SLN) and lymph outflow pathways in patients with biliary cancer (BC). MATERIAL AND METHODS: From April 2023 till March 2024, ten liver resections for BC were performed using FLG. We carried out the standard lymph node dissection with additional removal of lymph nodes (LN) that have accumulated indocyanine green (ICG). The lymphatic outflow pathways in all patients and frequency of SLN invasion were evaluated. RESULTS: Ten patients were included: five patients had been diagnosed with intrahepatic cholangiocarcinoma (IHCC), two - with perichilar tumor (PT), the last three ones had gallbladder cancer (GBC). SLN No. 1 were detected in eight patients, the accumulation of ICG was detected in the following groups of LN: No. 8 (n=2), No. 13 (n=1), No. 12b (n=2), cystic lymph node (n=2), and No. 7 (n=1). SLN No. 2 was detected in seven patients. In three cases LN No. 13 were stained, in one - LN No. 12a, in another - LN No. 8. In two patients, staining of vesicular LN was noted. The combined morphological assessment of SLN No. 1 and SLN No. 2 made it possible to predict the presence of LN metastases in all patients (100%, n=3). Fluorescence of third-order LN was detected in four patients. In one case, the staining of LN No. 13 was noted. Another patient revealed accumulation of ICG in LN No. 3. In two cases, at the third stage, fluorescence of LN N...