Laparoscopic observation of liver colored with indocyanine green in chronic hepatitis. I. Improved sensitivity for diagnosis of fibrosis.

We investigated the significance of intravenous injection of indocyanine green during laparoscopic examination in chronic hepatitis. The presence or absence of bridging fibrosis was estimated during laparoscopy from the pattern of lobular markings before and after indocyanine green coloration. Laparoscopy without indocyanine green predicted the presence of bridging fibrosis in biopsy specimens with a low sensitivity of 0.42 (specificity, 0.8). After intravenous injection of indocyanine green, lobular markings became clearer and the sensitivity of laparoscopy in the diagnosis of bridging fibrosis was markedly increased (sensitivity, 0.89; specificity, 0.8). These results indicate that the indocyanine green coloration method improves the correspondence between laparoscopy and liver biopsy in evaluating the severity of chronic hepatitis.