STAINING OF THE LIVER SURFACE WITH ICG AND ITS DIAGNOSTIC VALUE

Abstract

Laparoscopical studies were made on the liver surface among the 136 cases bearing chronic liver diseases, by means of staining method with indocyanine green (ICG). First of all, comparison was made on the relationship between intensity of the stain with ICG and the values of ICG test in chronic hepatitis, revealing positive correlation. Furthermore, it was examined whether ICG staining method contributed to increase diagnostic ability of chronic hepatitis as compared with ordinary laparoscopic examination. In succesion, although it is well known that ICG staining method is very valuable for the diagnosis of fatty liver and hepatocellular carcinoma (HCC), our experiment using the rats bearing fatty liver induced by ingestion of CCl4 showed similar eridence. ICG staining was also performed among the rats fed 2-acetylaminofluorene which is known to be hepatocarcinogen. HCC was not stained with ICG even in the rat as well as liver cancer in human. It was very interesting finding that in hyperplastic nodules focused as premalignant lesion of HCC some nodules were stained, but the others not. Any histological differences were not observed between ICG stained and not stained hyperplastic nodules. Based upon the data that HCC can not be stained with ICG, it can be said that stained hyperplastic nodules should be under remodeling to the normal hepatocytes. Thus, if ICG negative nodules can be observed in cirrhotic nodules, these lesions should be focused as HCC or border line lesion of HCC.