荧光导航技术在防止胆道损伤、发现胆漏中的作用  

The role of fluorescent cholangiography in preventing biliary tract injury and finding bile leakage

作　　者：王潇宁 吴硕东[1] 韩金岩[1] 邓天麟[1] 汪聪 王瀚 Wang Xiaoning;Wu Shuodong;Han Jinyan;Deng Tianlin;Wang Cong;Wang Han(Department of General SurgeryⅡ,Shengjing Hospital of China Medical University,Shenyang 110004,China)

机构地区：[1]中国医科大学附属盛京医院第二普通外科,沈阳110004

出　　处：《中华医学杂志》2023年第16期1242-1244,共3页National Medical Journal of China

摘　　要：本文探讨了腹腔镜胆囊切除术(LC)以及腹腔镜胆总管探查术(LCBDE)应用吲哚菁绿(ICG)荧光胆道造影技术在防止胆道损伤(BDI)和发现胆漏中的临床价值。选取2020年6月至2022年9月于中国医科大学附属盛京医院第二普通外科收治的行荧光导航LC以及LCBDE的患者300例为研究对象,对典型病例、操作过程及治疗结果进行观察分析。其中男114例,女186例,年龄(50.7±14.0)岁,体质指数(BMI)(23.6±1.6)kg/m^(2)。300例荧光导航手术均成功完成,其中5例患者施行荧光导航LCBDE并给予一期缝合。研究结果发现应用ICG荧光胆道造影技术可有效防止BDI、避免胆汁渗漏的发生,同时有理由提出假设:当怀疑胆汁渗漏进行二次手术时,可使用ICG进行快速定位以及术毕前检查,预防胆漏的再次发生。The study investigated the clinical value of fluorescence cholangiography using indocyanine green(ICG)in laparoscopic cholecystectomy(LC)and laparoscopic common bile duct exploration(LCBDE)in preventing bile duct injury(BDI)and detecting bile leakage.A total of 300 patients who underwent fluorescent navigation LC and LCBDE in the Second Department of General Surgery,Shengjing Hospital Affiliated to China Medical University from June 2020 to September 2022 were selected as the research objects for observation and analysis.There were 114 males and 186 females,and aged(50.7±14.0)years with the body mass index(BMI)of(23.6±1.6)kg/m^(2).All 300 cases of fluorescence navigation surgery were successfully completed,of which 5 patients received fluorescence-guided LCBDE and primary suture.The results showed that the application of fluorescence cholangiography with ICG can effectively avoid and detect the occurrence of BDI and bile leakage.Meanwhile,it is reasonable to hypothesize that ICG can be used for rapid localization and the final check to prevent the recurrence of bile leakage when bile leakage is suspected in the second operation.

关 键 词：胆管 吲哚菁绿 胆道造影术 腹腔镜 

分 类 号：R657.4[医药卫生—外科学]