The use of fluorescence laparoscopy in the resection of splenic tissue replantation in the right lobe of the liver: A case report and literature review
Affiliations: Department of Hepatobiliary and Pancreatic Surgery, The Second People’s Hospital of Changzhou Affiliated to Nanjing Medical University, Changzhou, Jiangsu, China
Correspondence:
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Corresponding author: Xi-Hu Qin, Department of Hepatobiliary and Pancreatic Surgery, The Second People’s Hospital of Changzhou Affiliated to Nanjing Medical University, No. 29 Xinglong Lane, Changzhou, Jiangsu 213003, China. E-mail: [email protected].
Abstract: BACKGROUND: Ectopic replantation and regeneration of splenic tissue fragments following splenic trauma or splenectomy is known as replantation of splenic tissue. It typically takes place in the abdominal cavity, however, splenic tissue replantation in the liver is extremely rare and difficult to diagnose. It is often misdiagnosed as a liver tumor and removed. CASE PRESENTATION: We present the case of a patient with a history of traumatic splenectomy 15 years prior to the replantation of splenic tissue in the liver. A 4 cm mass in the liver was found during the most recent physical examination, and a computed tomography scan indicated the possibility of a malignant tumor. The tumor was then removed using fluorescence laparoscopy. CONCLUSION: There is a possibility of intrahepatic replantation of splenic tissue in patients who have had a splenectomy in the past, have recently discovered an intrahepatic space-occupying lesion, and do not have any high-risk factors for liver cancer. Unnecessary surgery can be avoided if 99mTc-labeled red blood cells imaging using mass puncture or radionuclide examination provides a clear preoperative diagnosis. Globally, there are no reports of the use of fluorescence laparoscopy in resecting replanted splenic tissue in the liver. Specifically, in the current case, there was no indocyanine green uptake in the mass, and only a small amount was found in the normally functioning liver tissue surrounding the tumor.
Keywords: Fluorescence laparoscopy, hepatectomy, liver tumor, replantation of splenic tissue
