三维CT重建联合ICG荧光染色技术在先天性胆管扩张症腹腔镜根治术中的应用  被引量:8

Application of three-dimensional computed tomography reconstruction plus indocyanine green fluorescent staining technique in radical laparoscopy for congenital biliary dilatation.

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作  者:袁妙贤[1] 尹强[1] 季春宜[1] 彭宇明 高红强[1] 盛新仪 谢惟心 Yuan Miaoxian;Yin Qiang;Ji Chunyi;Peng Yuming;Gao Hongqiang;Sheng Xinyi;Xie Weixin(Department of General Surgery,Hunan Children's Hospital,Changsha 410007,China)

机构地区:[1]湖南省儿童医院普外一科,湖南省长沙市410007

出  处:《临床小儿外科杂志》2020年第7期614-618,共5页Journal of Clinical Pediatric Surgery

基  金:湖南省卫健委重点专科建设技术创新项目(编号:湘卫医政医管处函[2018]187号)。

摘  要:目的探讨三维CT重建联合ICG荧光染色在腹腔镜先天性胆管扩张症根治术中的应用价值。方法回顾性分析2019年8月至11月湖南省儿童医院收治的10例经三维CT重建联合ICG荧光染色技术引导完成的腹腔镜先天性胆管扩张症根治术患儿临床资料,观察术中所见与术前规划的符合程度,并记录手术时间、术中出血量、住院时间、并发症等资料。结果10例均在三维CT重建联合ICG荧光染色技术引导下顺利完成腹腔镜先天性胆管扩张症根治术,术前手术方案与实际手术方式符合率为100%;平均手术时间183.4 min,术中出血量10~35 mL,平均住院时间10.7d;术中1例发现胆漏,及时予以处理。患者均未出现ICG过敏、吻合口狭窄、胆漏、胰漏、胆管炎、胰腺炎等并发症。结论三维CT重建联合ICG荧光染色技术可清晰显示扩张胆管的位置及其与相邻组织的解剖关系;预防血管等副损伤,提高手术质量,增加手术安全性,值得临床推广。Objective To explore the application value of three-dimensional computed tomography(CT)reconstruction plus indocyanine green(ICG)fluorescent staining during radical laparoscopy of congenital cholangiectasia(CHD).Methods From August 2019 to November 2019,clinical data were retrospectively analyzed for 10 CHD children.And degree of conformity,operative duration,intraoperative bleeding volume,hospitalization stay and complications were observed.Results All CHD cases successfully completed radical laparoscopy under the guidance of three-dimensional CT reconstruction plus ICG fluorescent staining.The coincidence rate between preoperative operative plan and actual protocol was 100%;the average operative duration 183.4 min,the intraoperative bleeding volume 10-35 ml and the average hospitalization stay 10.7 days.One case of bile leakage was treated timely.There were no such complications as ICG allergy,anastomotic stenosis,bile leakage,pancreatic leakage,cholangitis or pancreatitis.Conclusion Three-dimensional CT reconstruction plus ICG fluorescent staining may distinctly delineate the location of dilated bile duct and depict its anatomical relationship with adjacent tissues.With heightened operative security,it is worthy of wider clinical applications.

关 键 词:胆总管扩张症/外科学 胆总管扩张症/先天性 成像 三维 ICG荧光染色 

分 类 号:R657.4[医药卫生—外科学] R445[医药卫生—临床医学]

 

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