目的：探讨吲哚菁绿（ICG）荧光影像技术对原发性肝癌肝切除术的指导价值与对病人近期预后的分析。方法：回顾性采集了上海交通大学医学院附属第一人民医院肝胆外科2018年6月至2021年6月行肝癌切除术的166例原发性肝癌病人病例的临床资料，并按照病人术中是否使用ICG荧光影像技术分为ICG组（72例）和非ICG组（94例）。比较两组术前、术中、术后资料，并对ICG组病人肿瘤病灶的ICG荧光图像进行分析。结果：ICG荧光强度与肿瘤病理组织学、分化程度、肝硬化与否相关。肝细胞癌多显示为部分荧光，而肝内胆管癌多显示为环状荧光。高分化肿瘤多为完全荧光（7/11），中分化肿瘤多为部分荧光（28/51），低分化肿瘤多为环形荧光（7/10）。肝硬化病人多为部分荧光（18/35）或完全荧光（13/35）。ICG组血白蛋白水平术后第1天（34.6 g/L比31.4 g/L）及第3天（32.4 g/L比31.2 g/L）高于非ICG组（P<0.001），而手术时间（170 min比210 min）、肝门阻断率（9.7%比33.0%）、术中出血量（400 mL比430 mL）、术后住院时间（10 d比14 d）、术后近期并发症发生率（4.2%比20.2%）明显低于非ICG组（P<0.05）。结论：ICG荧光强度与原发性肝癌肿瘤病理组织学、分化程度、肝硬化与否相关。ICG荧光影像技术合理应用减少手术时间，且有利于提高病人近期预后，加速病人术后的康复。

Objective To explore the efficiency of indocyanine green (ICG) fluorescence imaging-guided hepatectomy and its short-term prognosis in patients with primary liver carcinoma. Methods Retrospective analysis was conducted on 166 patients diagnosed with primary liver carcinoma and admitted to the Department of Hepatobiliary Surgery of Shanghai General Hospital affiliated to Shanghai Jiao Tong University School of Medicine from June 2018 to June 2021. Patients were categorized into ICG group (n=72) and non-ICG group (n=94) based on the utilization of ICG during surgery. Moreover, the clinical information of preoperation, intraoperation, and postoperation were collected and compared between the two groups. ICG fluorescence images of the lesions in the ICG group were recorded for analysis. Results ICG fluorescence intensity is associated with the histopathology, differentiation grade of primary liver cancer, and the presence of liver cirrhosis. Hepatocellular carcinoma lesions predominantly displayed partial fluorescence, while intrahepatic cholangiocarcinoma lesions showed circular fluorescence. Well differentiated tumors exhibited complete fluorescence (7/11), moderately differentiated tumors demonstrated partial fluorescence (28/51), and poorly differentiated tumors displayed circular fluorescence (7/10). Most patients with liver cirrhosis exhibited partial fluorescence (18/35) or complete fluorescence (13/35).Compared to the non-ICG group, the ICG group demonstrated higher serum albumin levels on the first (34.6 g/L vs. 31.4 g/L) and the third postoperative days (32.4 g/L vs. 31.2 g/L)(P<0.001). Conversely, the ICG group showed shorter operation time (170 min vs. 210 min), lower rate of intraoperative hepatic portal blockade (9.7% vs. 33.0%), less intraoperative blood loss (400 mL vs. 430 mL), shorter postoperative hospital stay (10 d vs. 14 d), and lower incidence of short-term postoperative complications (4.2% vs. 20.2%) (P<0.05) compared to the non-ICG group. Conclusions ICG fluorescence intensity is associated with the histopathology, differentiation grade of primary liver cancer, and the presence of liver cirrhosis.The judicious application of ICG fluorescence imaging technology alongside surgical techniques holds promise for improving short-term prognosis and expediting the postoperative recovery.