吲哚菁绿荧光显像引导在腹腔镜肝中叶切除术中的应用

目的探讨吲哚菁绿(indocyanine green,ICG)荧光显像引导在腹腔镜肝中叶切除术中的应用价值。方法回顾性分析2016年9月至2018年11月期间实施中肝切除手术病人的临床及病理资料,包括手术方式、ICG荧光显像方式、病理结果、术后肝功能恢复时间、并发症、住院时间等。结果 24例行中肝切除术的病人中,开腹中肝切除术11例,ICG荧光显像引导的腹腔镜中肝切除术13例。无围手术期死亡病例,术后共发生Clavien-DindoⅢ级并发症3例。腹腔镜组较开腹组手术时间更长(261±80) min比(201±40) min,P<0.05],但术后肝功能恢复更快,住院时间更短(8.5±3.3) d比(11.7±4.0) d,P<0.05]。结论腹腔镜中肝切除术是中央区肝肿瘤的一种安全可行治疗手段,术中应用ICG荧光显像引导技术可进一步提高手术的安全性和有效性。

Application of indocyanine green fluorescence imaging in laparoscopic hepatic middle lobe resection

Objective To investigate the clinical value of indocyanine green(ICG)fluorescence imaging technique in laparoscopic mesohepatectomy.Methods A retrospective analysis was performed on the clinical and pathological data of patients undering mesohepatectomy from September 2016 to November 2018,including surgical methods,ICG fluorescence navigation,pathological results,postoperative liver function,complications and length of hospital stay.Results Of the 24 patients with mesohepatectomy,11 patients underwent open mesohepatectomy and 13 patients were given ICG fluorescence imaging guided laparoscopic mesohepatectomy.There were no perioperative deaths.Clavien-Dindo gradeⅢcomplication occurred in 3 cases.The operation time was significantly longer(261±80 min vs.201±40 min,P<0.05),but the liver function recovered significantly faster and the average hospital stay was significantly shorter in laparoscopic group(8.5±3.3 vs.11.7±4.0 days,P<0.05)than those in open group.Conclusion Mesohepatectomy is a safe and feasible treatment for central liver tumor.ICG fluorescence imaging technique can further improve the safety and effectiveness during laparoscopic hepatectomy.