目的:探讨吲哚菁绿荧光引导腹腔镜解剖性肝段获取术在小儿活体肝移植中的应用价值。方法:采用回顾性描述性研究方法。收集2019年12月至2020年1月首都医科大学附属北京友谊医院收治的2例行活体肝移植患儿和2例供者的临床资料。病例1，女，年龄为1岁，体质量为8.7 kg。供者为患儿父亲，年龄为35岁，体质量为93.1 kg。病例2，男，年龄为1岁，体质量为7.5 kg。供者为患儿父亲，年龄为39岁，体质量为84.0 kg。2例供者均行吲哚菁绿荧光引导腹腔镜解剖性肝段获取术获取供肝。观察指标：（1）供者手术情况。（2）供者术后情况。（3）受者术后情况。（4）随访情况。采用电话、门诊、短信、微信方式进行随访。供者于术后第1、3、6个月随访1次，了解肝功能恢复情况。受者于术后每周随访1次，了解移植物功能情况，以及排斥反应、胆汁漏、胆道狭窄、血栓形成、血管狭窄等并发症发生情况。随访时间截至2020年7月。结果:（1）供者手术情况。病例1供者总手术时间为234 min，供肝减体积处理时间为40 min，术中出血量为60 mL，未输血。经减体积处理后供肝实际质量为225.2 g。病例2供者总手术时间为220 min，供肝减体积处理时间为40 min，术中出血量为40 mL，未输血。经减体积处理后供肝实际质量为178.0 g。（2）供者术后情况。病例1供者丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）、总胆红素（TBil）于术后第2天达到峰值，分别为493 U/L、186.0 U/L、30.66 μmol/L，于术后第3天下降为388 U/L、90.9 U/L、22.57 μmol/L；术后首次下床活动时间为术后2 d、术后首次进食流质食物时间为术后1 d、术后拔除腹腔引流管时间为术后3 d、术后住院时间为4 d、围术期无≥Clavien-Dindo Ⅱ级并发症发生。病例2供者ALT、AST、TBil于术后第1天达到峰值，分别为602 U/L、454.6 U/L、30.49 μmol/L，于术后第4天下降为355 U/L、55.7 U/L、20.65 μmol/L；术后首次下床活动时间为术后2 d、术后首次进食流质食物时间为术后1 d、术后拔除腹腔引流管时间为术后3 d、术后住院时间为5 d、围术期无≥Clavien-Dindo Ⅱ级并发症发生。（3）受者术后情况。病例1 ALT、AST、TBil于术后第1天达到峰值，分别为670 U/L、288.7 U/L、22.13 μmol/L，于术后第14天下降为54 U/L、33.0 U/L、5.75 μmol/L；术后住院时间为20 d，围术期无≥Clavien-Dindo Ⅱ级并发症发生。病例2 ALT、AST、TBil于术后第1天达到峰值，分别为520 U/L、93.9 U/L、31.42 μmol/L，于术后第14天下降为87 U/L、60.8 U/L、11.51 μmol/L；术后住院时间为25 d，围术期无≥Clavien-Dindo Ⅱ级并发症发生。（4）随访情况。2例供者均获得术后1、3、6个月随访，术后1个月随访肝功能恢复至正常水平，术后3个月及6个月随访肝功能未见异常。2例受者均获得术后每周随访。随访期间，移植物功能均正常，均未发生排斥反应、胆汁漏、胆道狭窄、血栓形成、血管狭窄等并发症。结论:吲哚菁绿荧光引导腹腔镜解剖性肝段获取术应用于小儿活体肝移植安全、可行，可由具有丰富腹腔镜供肝获取手术经验的团队施行。“,”Objective:To investigate the application value of indocyanine green fluorescence(ICG)-guided laparoscopic anatomical monosegmentectomy in pediatric living donor liver transplantation.Methods:The retrospective and descriptive study was conducted. The clinical data of 2 pediatric recipients undergoing living donor liver transplantation and 2 donors who were admitted to the Beijing Friendship Hospital Affiliated to Capital Medical University from December 2019 to January 2020 were collected. Case 1 was female, aged 1 year, weighted 8.7 kg. The living donor was the father of case 1, aged 35 years and weighted 93.1 kg. Case 2 was male, aged 1 year, weighted 7.5 kg. The living donor was the father of case 2, aged 39 years and weighted 84.0 kg. Both of 2 donors underwent ICG-guided laparoscopic anatomical monosegmentectomy to obtain the graft. Observation indicators: (1) surgical situations of donors; (2) postoperative situations of donors; (3) postoperative situations of recipients; (4) follow-up. Follow-up was conducted using telephone interview, outpatient examination, mobile short message or the WeChat. Donors were followed up at postoperative 1, 3, 6 months to detect recovery of liver function. Recipients were followed up once a week postoperatively to detect graft function and complications including rejection, bile leakage, biliary stenosis, thrombosis, vascular stenosis up to July 2020.Results:(1) Surgical situations of donors: the total operation time, time of preparing reduced-size grafts, volume of intraoperative blood loss of the donor of case 1 were 234 minutes, 40 minutes, 60 mL, respectively. There was no blood transfusion during the operation and the final graft weight was 225.2 g after reducing size. The total operation time, time of preparing reduced-size grafts, volume of intra-operative blood loss of the donor of case 2 were 220 minutes, 40 minutes, 40 mL, respectively. There was no blood transfusion during the operation and the final graft weight was 178.0 g after reducing size. (2) Postoperative situations of donors: on the postoperative second day, the levels of alanine amino-transferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBil)of the donor of case 1 reached the peak of 493 U/L, 186.0 U/L, 30.66 μmol/L, respectively, and then decreased to 388 U/L, 90.9 U/L, 22.57 μmol/L on the postoperative third day. The time to postoperative out-of-bed activity, time to postoperative initial liquid food intake, time to postoperative abdominal drainage tube removal, duration of postoperative hospital stay of the donor of case 1 were 2 days, 1 day, 3 days, 4 days, respectively. There was no Clavien-Dindo grade Ⅱ-Ⅴ complication occurred during the perioperative period. On the postoperative first day, the level of ALT, AST, TBil of the donor of case 2 reached the peak of 602 U/L, 454.6 U/L, 30.49 μmol/L, respectively, and then decreased to 355 U/L, 55.7 U/L,20.65 μmol/L on the postoperative fourth day. The time to postoperative out-of-bed activity, time to postoperative initial liquid food intake, time to postoperative abdominal drainage tube removal, duration of postoperative hospital stay of the donor of case 2 were 2 days, 1 day, 3 days, 5 days, respectively. There was no Clavien-Dindo grade Ⅱ-Ⅴcomplication occurred during the perioperative period. (3) Postoperative situations of recipients: on the postoperative first day, the levels of ALT, AST, TBil of case 1 reached the peak of 670 U/L, 288.7 U/L, 22.13 μmol/L, respectively, and then decreased to 54 U/L, 33.0 U/L, 5.75 μmol/L on the postoperative fourteenth day. The duration of postoperative hospital stay of case 1 was 20 days and there was no Clavien-Dindo grade Ⅱ-Ⅴ complication occurred during the perioperative period. On the postoperative first day, the levels of ALT, AST, TBil of case 2 reached the peak of 520 U/L, 93.9 U/L, 31.42 μmol/L, respectively, and then decreased to 87 U/L, 60.8 U/L, 11.51 μmol/L on the postoperative fourteenth day. The duration of postoperative hospital stay of case 2 was 25 days and there was no Clavien-Dindo grade Ⅱ-Ⅴ complication occurred during the perioperative period. (4) Follow-up: 2 donors were followed up at postoperative 1, 3, 6 months. The liver function of 2 donors recovered to normal level at postoperative 1 month, and no abnormal liver function was found at postoperative 3 months or 6 months. Two recipients were followed up weekly after. During the follow-up, both recipients had normal graft function and no complication such as rejection, bile leakage, biliary stricture, thrombosis or vascular stenosis emerged.Conclusion:ICG-guided laparoscopic anatomical mono-segmentectomy is safe and feasible in pediatric living donor liver transplantation, which can be performed by a team with rich experience in laparoscopic liver graft acquisition.