Laparoscopic hepatectomy using indocyanine green attenuates postoperative inflammatory response for hepatocellular carcinoma: A propensity score matching analysis

Table 1 General clinicopathologic characteristics, n (%)

Variables	All patients (n = 107)				Propensity-matched patients (n = 94)
	Total (n = 107)	ICG (n = 47)	Non-ICG (n = 60)	P value	Total (n = 94)	ICG (n = 47)	Non-ICG (n = 47)	P value
Sex				0.235				0.789
Male	83 (77.6)	39 (83.0)	44 (73.3)		77 (81.9)	39 (83.0)	38 (80.9)
Female	24 (22.4)	8 (17.0)	16 (26.7)		17 (18.1)	8 (17.0)	9 (19.1)
Age, years	58.4 (11.1)	55.2 (12.2)	61.0 (9.5)	0.007	57.5 (11.1)	55.2 (12.2)	59.7 (9.4)	0.059
Hepatitis serology				0.045				0.313
None	28 (26.2)	8 (17.0)	20 (33.3)		20 (21.3)	8 (17.0)	12 (25.5)
HBV	79 (73.8)	39 (83.0)	40 (66.7)		74 (78.7)	39 (83.0)	35 (74.5)
PRE-OP Alb, g/L	43.0 (3.7)	43.0 (3.5)	43.0 (3.9)	0.959	43.0 (3.7)	43.0 (3.5)	42.9 (3.9)	0.934
PRE-OP TBil, μmol/L	11.6 (6.5)	12.2 (7.7)	11.1 (5.4)	0.401	11.9 (6.8)	12.2 (7.7)	11.6 (5.7)	0.650
PRE-OP ALT, U/L	26.3 (14.9)	27.6 (17.5)	25.3 (12.5)	0.437	26.3 (15.4)	27.6 (17.5)	25.1 (12.9)	0.443
PRE-OP AST, U/L	24.7 (8.3)	23.4 (6.6)	25.7 (9.3)	0.455	23.7 (7.0)	23.4 (6.6)	24.0 (7.5)	0.715
Tumor location				0.2				0.272
caudal lobe	2 (1.9)	1 (2.1)	1 (1.7)		2 (2.1)	1 (2.1)	1 (2.1)
Left lateral lobe	8 (7.5)	6 (12.8)	2 (3.3)		8 (8.5)	6 (12.8)	2 (4.3)
Left medial lobe	15 (14.0)	9 (19.1)	6 (10.0)		14 (14.9)	9 (19.1)	5 (10.6)
Right anterior lobe	42 (39.3)	16 (34.0)	26 (43.3)		41 (43.6)	16 (34.0)	25 (53.2)
Right posterior lobe	40 (37.4)	15 (31.9)	25 (41.7)		29 (30.9)	15 (31.9)	14 (29.8)
Tumor size, cm	3.1 (1.6)	2.9 (1.7)	3.3 (1.5)	0.256	3.1 (1.6)	2.9 (1.7)	3.3 (1.6)	0.234
Tumor amount				0.282				0.212
Single	97 (90.7)	41 (87.2)	56 (93.3)		85 (90.4)	41 (87.2)	44 (93.6)
Multiple	10 (9.3)	6 (12.8)	4 (6.7)		9 (9.6)	6 (12.8)	3 (6.4)
Histological grading				0.341				0.460
I-II	96 (89.7)	44 (93.6)	52 (86.7)		86 (91.5)	44 (93.6)	42 (89.4)
III	11 (10.3)	3 (6.4)	8 (13.3)		8 (8.5)	3 (6.4)	5 (10.6)
Degree of hepatic fibrosis				0.426				0.408
0-III	57 (53.3)	23 (48.9)	34 (56.7)		50 (53.2)	23 (48.9)	27 (57.4)
IV	50 (46.7)	24 (51.1)	26 (43.3)		44 (46.8)	24 (51.1)	20 (42.6)
MVI				0.146				0.298
M0	63 (58.9)	24 (51.1)	39 (65.0)		53 (56.4)	24 (51.1)	29 (61.7)
M1-2	44 (41.1)	23 (48.9)	21 (35.0)		41 (43.6)	23 (48.9)	18 (38.3)

PRE-OP: Pre-operation; ICG: Indocyanine green; HBV: Hepatitis B virus; Alb: Albumin; TBil: Total bilirubin; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; MVI: Microvascular invasion.

Table 2 Specific intra-operative outcomes, n (%)

Variables	Total (n = 94)	ICG (n = 47)	Non-ICG (n = 47)	P value
Blood loss, mL	124.4 (111.8)	85.5 (59.6)	163.2 (136.5)	0.001
Surgery time, minute	152.6 (62.4)	128.2 (43.6)	177.0 (68.9)	< 0.001
HIO times				0.005
0	5 (5.3)	4 (8.5)	1 (2.1)
1	30 (31.9)	20 (42.6)	10 (21.3)
2	40 (42.6)	20 (42.6)	20 (42.6)
3	17 (18.1)	2 (4.3)	15 (31.9)
4	2 (2.1)	1 (2.1)	1 (2.1)
Total HIO time, minute	28.9 (13.6)	25.1 (13.2)	32.7 (13.2)	0.007
Margin, mm	8.6 (6.9)	8.8 (6.4)	8.3 (7.5)	0.724

HIO: Hepatic inflow occlusion; ICG: Indocyanine green.

Table 3 Specific post-operative outcomes, n (%)

Variables	Total (n = 94)	ICG (n = 47)	Non-ICG (n = 47)	P value
POST-OP PT1, second	13.9 (1.1)	13.9 (0.9)	13.9 (1.2)	0.829
POST-OP TBil1, μmol/L	26.4 (13.5)	27.5 (14.2)	25.2 (12.7)	0.418
POST-OP ALT1, U/L	272.1 (236.1)	247.5 (159.0)	296.7 (290.3)	0.311
POST-OP AST1, U/L	238.0 (255.1)	200.0 (129.7)	275.9 (334.4)	0.151
POST-OP hospitalization, days	7.1 (2.6)	6.5 (1.2)	7.6 (3.4)	0.030
Clavien-Dindo complications				0.399
None or grade I	88 (93.6)	45 (95.7)	43 (91.5)
Grade II	6 (6.4)	2 (4.3)	4 (8.5)
POST-OP TACE				0.674
Negative	56 (59.6)	29 (61.7)	27 (57.4)
Positive	38 (40.4)	18 (38.3)	20 (42.6)
Recurrence				1.000
Negative	88 (93.6)	44 (93.6)	44 (93.6)
Positive	6 (6.4)	3 (6.4)	3 (6.4)

¹Maximum value.

POST-OP: Post-operation; ICG: Indocyanine green; PT: Prothrombin time; TBil: Total bilirubin; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; TACE: Transcatheter arterial chemoembolization.

Table 4 Trends of inflammation-related markers during the perioperative period

Variables	Total (n = 94)	ICG (n = 47)	Non-ICG (n = 47)	P value
PRE-OP inflammation-related markers
CRP	1.8 (3.5)	1.8 (4.4)	1.7 (2.2)	0.918
NLR	1.9 (0.8)	1.9 (0.9)	1.9 (0.8)	0.990
PLR	98.7 (35.5)	95.5 (33.2)	101.8 (37.8)	0.395
LMR	4.0 (1.5)	4.0 (1.3)	3.9 (1.8)	0.701
SII	345.2 (200.0)	332.6 (196.9)	357.8 (204.4)	0.544
POST-OP inflammation-related markers
CRP1	70.5 (49.8)	61.1 (49.4)	80.0 (49.0)	0.066
D1 NLR	8.5 (4.7)	8.2 (4.1)	8.8 (5.3)	0.536
D1 PLR	148.2 (67.8)	134.3 (53.6)	162.1 (77.6)	0.046
D1 LMR	1.6 (0.8)	1.5 (0.8)	1.6 (0.7)	0.619
D1 SII	1306.9 (813.9)	1197.3 (644.4)	1416.5 (948.4)	0.193
D3 NLR	5.4 (4.1)	4.5 (2.9)	6.3 (4.9)	0.033
D3 PLR	107.7 (61.0)	102.0 (40.0)	113.3 (76.6)	0.373
D3 LMR	2.4 (3.9)	2.0 (0.8)	2.9 (5.5)	0.278
D3 SII	708.7 (569.3)	601.3 (451.5)	816.1 (654.0)	0.067

¹Maximum value; D1/D3 One/three day(s) after surgery.

PRE-OP: Pre-operation; POST-OP: Post- operation; CRP: C-reactive protein; NLR: Neutrophil-lymphocyte ratio; PLR: Platelet-lymphocyte ratio; LMR: Lymphocyte-monocyte ratio; SII: Systemic immune inflammation index; ICG: Indocyanine green.