吲哚菁绿荧光联合三维可视化技术应用于腹腔镜肝脏血管瘤切除  

Application of indocyanine green fluorescence combined with three-dimensional visualization technology in laparoscopic he-patic hemangioma resection

作　　者：周毅 余继海 张传海 王一帆 李国芹 马金良 ZHOU Yi;YU Ji-hai;ZHANG Chuan-hai(The Anhui Provical University,Hefei 230001,China)

机构地区：[1]安徽医科大学附属省立医院肝脏外科,合肥230001

出　　处：《肝胆外科杂志》2022年第1期29-32,共4页Journal of Hepatobiliary Surgery

基　　金：安徽省重点研究和开发计划项目(No.804h08020281);安徽省自然科学基金项目资助项目(编号:1608085MH198)。

摘　　要：目的评价吲哚菁绿(1CG)荧光联合三维可视化技术在引导腹腔镜肝脏血管瘤切除中的可行性及疗效.方法收集2020年1月至2021年5月在安徽医科大学附属省立医院肝脏外科收治的11例行ICG荧光联合三维可视化技术行腹腔镜肝脏血管瘤切除的患者.所有患者术前行三维重建制定个性化手术方案,术前24~48 h外周静脉推注12.5mgICG,术中使用吲哚菁绿荧光精准引导腹腔镜肝脏血管瘤切除.结果所有病人术前三维重建拟定的手术方案及均与术中所见相同,11例病人中10例病人术中荧光显影可见明显绕肿瘤的环状荧光带,成功在ICG荧光引导下行腹腔镜肝脏血管瘤切除,1例病人肿瘤外生性生长,显影失败,未见明显环状荧光带.11例病人术中出血100(50~600)ml,肝门阻断时间30(0~70)min,手术时长180(100~290)min,术中1个病人输血,其余病人未输血,术后住院时间为5(3~9)d,术后峰值ALT为231(67~933)U/L,AST为259(51~783)U/L,TBil为12.5(7.7~17.6)μmol/L,ALB为37(33.2~40.1)g/L,术后仅1例病人出现胸腔积液,其余病人未出现明显并发症,术后病理学检查提示11例病人均为海绵状血管瘤.结论ICG荧光联合三维可视化技术引导的腹腔镜肝脏血管瘤切除可在保留更多肝实质的同时,获得更安全的切缘,且操作简单可行,有良好的临床应用前景.Objective To evaluate the feasibility and efficacy of indocyanine green(ICG)fluorescence combined with three-dimensional visualization technology in guided laparoscopic hepatic hemangioma resection.Methods From January 2020 to May 2021,11 patients who underwent laparoscopic liver hemangioma resection with ICG fluorescence combined with three-dimensional visualization technology who were admitted to the Department of Liver Surgery at the Provincial Hospital of Anhui Medical University were collected.All patients underwent three-dimensional reconstruction before the operation to develop a personalized surgical plan.The peripheral intravenous bolus of 12.5 mg ICG was injected 24 to 48 hours before the operation.Results The preoperative three-dimensional reconstruction of all the patients surgical plans were the same as those seen during the operation.Intraoperative fluorescence of 10 of the 11 patients showed obvious circular fluorescent bands around the tumor.The liver was successfully laparoscopically guided by ICG fluorescence.The hemangioma was removed,and the tumor grew exogenously in one patient,and the imaging failed.No obvious ring-shaped fluorescent band was seen.In 11 patients,intraoperative blood loss was 100(50-600)ml,hepatic port occlusion time was 30(0-70)min,and the operation time was 180(100-290)min.One patient had blood transfusion during the operation,and the rest of the patients had no blood transfusion.The post-hospital stay was 5(3-9)days,the postoperative peak ALT was 231(67-933)U/L,AST was 259(51-783)U/L,and TBil was 12.5(7.7-17.6)pmol/L,ALB was 37(33.2〜40.1)g/L,only 1 patient had pleural effusion after operation,and the remaining patients had no obvious complications.Postoperative pathological examination showed that 11 patients were cavernous hemangioma.Conclusion The laparoscopic hepatic hemangioma resection guided by ICG fluorescence combined with three-dimensional visualization technology can preserve more liver parenchyma while obtaining a safer margin,and the operation is simple and f

关 键 词：吲哚菁绿 三维可视化 腹腔镜肝切除 肝血管瘤 

分 类 号：R575[医药卫生—消化系统]