Partial Hepatic Vein Occlusion and Venous Congestion in Liver Exploration Using a Hyperspectral Camera: A Proposal for Monitoring Intraoperative Liver Perfusion
by
, , , , , , , and
Simone Famularo
1,2,3,*,
Elisa Bannone
3,4,
Toby Collins
3,
Elisa Reitano
3,
Nariaki Okamoto
3,5,
Kohei Mishima
3,
Pietro Riva
3,6,
Yu-Chieh Tsai
3,
Richard Nkusi
3,
Alexandre Hostettler
3,
Jacques Marescaux
3,6
,
Eric Felli
3,7
and
Michele Diana
3,5,6
1
Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20133 Milan, Italy
2
Department of Hepatobiliary and General Surgery, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy
3
Research Institute against Digestive Cancer (IRCAD), 67091 Strasbourg, France
4
Department of General Surgery, Poliambulanza Foundation Hospital, 25124 Brescia, Italy
5
Photonics Instrumentation for Health, iCube Laboratory, University of Strasbourg, 67000 Strasbourg, France
6
Department of General, Digestive and Endocrine Surgery, University Hospital of Strasbourg, 67000 Strasbourg, France
7
Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, 3012 Bern, Switzerland
*
Author to whom correspondence should be addressed.
Cancers 2023, 15(8), 2397; https://doi.org/10.3390/cancers15082397
Submission received: 7 March 2023
/
Revised: 14 April 2023
/
Accepted: 20 April 2023
/
Published: 21 April 2023
(This article belongs to the Special Issue Innovative Approaches to the Liver Tumors: Molecular, Imaging, Surgical and Artificial Intelligence Applications in Clinical Practice)
Simple Summary
No measures of the changes occurring in the liver in the case of outflow deprivation during hepatectomies are available. This study investigated four indexes obtained using hyperspectral imaging in a pig model, measured in different liver lobes, before and after hepatic vein occlusion. The variations of StO2% and deoxy-Hb were considerably good markers of venous liver congestion.
Abstract
Introduction. The changes occurring in the liver in cases of outflow deprivation have rarely been investigated, and no measurements of this phenomenon are available. This investigation explored outflow occlusion in a pig model using a hyperspectral camera. Methods. Six pigs were enrolled. The right hepatic vein was clamped for 30 min. The oxygen saturation (StO2%), deoxygenated hemoglobin level (de-Hb), near-infrared perfusion (NIR), and total hemoglobin index (THI) were investigated at different time points in four perfused lobes using a hyperspectral camera measuring light absorbance between 500 nm and 995 nm. Differences among lobes at different time points were estimated by mixed-effect linear regression. Results. StO2% decreased over time in the right lateral lobe (RLL, totally occluded) when compared to the left lateral (LLL, outflow preserved) and the right medial (RML, partially occluded) lobes (p < 0.05). De-Hb significantly increased after clamping in RLL when compared to RML and LLL (p < 0.05). RML was further analyzed considering the right portion (totally occluded) and the left portion of the lobe (with an autonomous draining vein). StO2% decreased and de-Hb increased more smoothly when compared to the totally occluded RLL (p < 0.05). Conclusions. The variations of StO2% and deoxy-Hb could be considered good markers of venous liver congestion.
