荧光腹腔镜保留十二指肠胰头切除术2例报告并文献复习(附手术视频)  

Fluorescent laparoscopic duodenum-preserving pancreatic head resection in two cases and literature review(with video)

作　　者：黄文涛[1] 游燊[1] 陈毅凌 洪嘉明 陈实[1] 田毅峰[1] 王耀东[1] 赖智德[1] HUANG Wentao;YOU Shen;CHEN Yiling;HONG Jiaming;CHEN Shi;TIAN Yifeng;WANG Yaodong;LAI Zhide(Department of He patopancrealobiliary Surgery,Fujian Provincial Hospital,Provincial Clinical Medical College of Fujian Medical University,Fuzhou,Fujian 350001,China)

机构地区：[1]福建医科大学省立临床医学院福建省立医院肝胆胰外科,福州350001

出　　处：《福建医药杂志》2021年第3期29-32,共4页Fujian Medical Journal

摘　　要：目的总结2例荧光腹腔镜保留十二指肠胰头切除术(FLDPPHR)的手术经验,并结合文献,分析FLD-PPHR的优势、发展现状.方法回顾性分析我科施行的2例FLDPPHR病例的临床资料,并进行相关文献复习.结果2例FLDPPHR均顺利完成,无中转手术.手术时间和术中出血量分别为450min、300mL和473min、400mL.吲哚菁绿荧光显像技术(ICG-FI)有助于术中对胆总管的实时显露.术后住院时间分别为14d、39d.术后病理诊断分别为胰管结石伴慢性胰腺炎和胰腺实性-假乳头状瘤.术后1例发生胆瘘,因远端胆管狭窄行胆肠吻合术;另1例发生B级胰瘘、胆瘘、少量的腹腔出血,因远端胆管狭窄行胆肠吻合术.结论在FLDPPHR中,ICG-FI是有价值的实时导航方法,有助于胆总管的暴露和保护,也可以作为胆瘘的检查手段.Objective To summarize the experience of fluorescent laparoscopic duodenum-preserving pancreatic head resection(LDPPHR)in two cases,and analyze the advantage and current development of these procedures with literature review.Methods The clinical data of two patients underwent FLDPPHR in Fujian Provincial Hospital was analyzed retrospectively,and relevant literature was reviewed.Results Two patients underwent FLDPPHR without laparotomy.The operation time and estimated blood loss was 450 min,300 mL and 473 min,400 mL,respectively.Indocyanine green fluorescence imaging(ICG-FI)could benefit the exposure of the common bile duct(CBD)in real time.The postoperative hospital stay of the two patients was 14 and 39 days,respectively.Pathologic results showed pancreatolithiasis complicated with chronic pancreatitis in one patient,and solid pseudopapillary neoplasm in the other.After surgery,one patient developed biliary fistula and received cholangiojejunostomy on account of distal bile duct stenosis,the other patient developed pancreatic fistula of grade B,biliary fistula,mild abdominal hemorrhage,and received cholangiojejunostomy on account of distal bile duct stenosis.Conclusion During the procedure of FLDPPHR,ICG-FI can benefit the exposure and protection of CBD in real time,and the detection of biliary fistula.

关 键 词：荧光腹腔镜 保留十二指肠胰头切除术 吲哚菁绿 胆道并发症 

分 类 号：R657.5[医药卫生—外科学]