术中实时影像学引导的腹腔镜肝切除  

Intraoperative real-time imaging-guided laparoscopic liver resection

作　　者：卢鹏 王宏光[1] Lu Peng;Wang Hongguang(Department of Hepatobiliary Surgery,First Medical Center,General Hospital of PLA,Beijing 100853,China;Department of Hepatobiliary Surgery,Hainan Hospital,General Hospital of Chinese PLA,Sanya 572000,China)

机构地区：[1]解放军总医院第一医学中心肝胆外科,北京100853 [2]解放军总医院海南医院肝胆外科,三亚572000

出　　处：《中国医师杂志》2020年第3期324-327,共4页Journal of Chinese Physician

基　　金：海南省自然科学基金面上项目(817357);海南省重点研发项目(ZDYF2017134);三亚市医疗卫生科技创新项目(2016YW13)。

摘　　要：近年来,腹腔镜肝脏切除手术发展迅速,但是这种手术方式也对外科医生提出了新的挑战。利用术中实时影像学引导技术可以有效解决腹腔镜手术方式的弊端。腹腔镜超声可以用来发现和诊断病灶性质、标记重要管道结构,确定切缘,引导穿刺。ICG荧光显像可应用于术中病灶的识别、定位、定性、特定肝段的标记以及术后胆漏的预防等方面。这两种技术是目前腹腔镜肝切除术中仅有的两项实时成像影像学引导技术,真正弥补了腹腔镜肝脏手术不能进行触诊、探查显露受限等缺点。In recent years,laparoscopic hepatectomy has developed rapidly,but new challenges are posed to surgeons because of this surgical approach.The disadvantages of laparoscopic surgery can be effectively solved by using intraoperative real-time imaging guidance technology.Laparoscopic ultrasound can be used to discover and diagnose the nature of lesions,mark the important pipeline structure,determine the cutting edge,and guide puncture.ICG fluorescence imaging can be applied to the identification,localization,characterization of intraoperative lesions,the marking of specific liver segments and the prevention of postoperative bile leakage.These two technologies are the only two real-time imaging guidance technologies in laparoscopic hepatectomy at present,which truly make up for the shortcomings of laparoscopic liver surgery such as the inability to palpate and limited exploration exposure.

关 键 词：腹腔镜检查 肝切除术 外科手术 影像引导 

分 类 号：R657.3[医药卫生—外科学]