中国普外基础与临床杂志

中国普外基础与临床杂志

利用吲哚菁绿荧光显像技术的腹腔镜下 Glisson 蒂横断式解剖性肝段切除

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目的 探讨利用吲哚菁绿荧光显像技术的腹腔镜下 Glisson 蒂横断式解剖性肝段切除的效果及安全性。 方法 回顾性分析四川大学华西医院肝脏外科收治的 1 例利用吲哚菁绿荧光显像技术的腹腔镜下 Glisson 蒂横断式解剖性肝段切除治疗的肝细胞肝癌患者的术前临床资料、手术治疗过程及术后情况。 结果 结合患者术前病史、影像学及实验室检查结果考虑诊断为肝细胞肝癌,术中探查发现肿瘤只有 1 个,位于Ⅳ段且较表浅,遂利用 ICG 荧光显像技术行 Glisson 蒂横断式解剖性肝段切除术,术后病理诊断符合肝细胞肝癌,无严重并发症发生,恢复良好,随访至今 6 个月未见复发。 结论 利用吲哚菁绿荧光显像技术的腹腔镜下 Glisson 蒂横断式解剖性肝切除术可被作为一种用以解决手术过程中出血、肿瘤边界难确定、手术切缘是否有残余肿瘤等问题的安全、精准的治疗手段。

Objective To evaluate efficacy and safety of laparoscopic Glisson pedicle transverse anatomical hepatectomy using indocyanine green (ICG) fluorescence imaging. Method The retrospective analysis was made on the preoperative clinical data, surgical treatment and postoperative status of a patient with hepatocellular carcinoma who underwent the laparoscopic Glisson pedicle transverse anatomical hepatectomy using the indocyanine green fluorescence imaging technology in the Department of Liver Surgery, West China Hospital, Sichuan University. Results According to the preoperative history, imaging and laboratory examinations, the diagnosis of hepatocellular carcinoma was considered. The intraoperative exploration revealed that there was only one tumor located in the segment Ⅳ and was superficial. The ICG fluorescence imaging was used to perform the Glisson pedicle transverse anatomical hepatectomy. The postoperative pathological diagnosis was consistent with hepatocellular carcinoma without serious complications. The patient recovered well. No recurrence was found in the follow-up period up to 6 months. Conclusions Laparoscopic Glisson pedicle transection anatomic hepatectomy using ICG fluorescence technology can be used as a safe and precise treatment to solve problems such as bleeding during operation, difficult determination of tumor boundary and whether having residual tumor in surgical margin.

关键词: 吲哚菁绿荧光显像技术; 腹腔镜肝切除术; 解剖性肝切除

Key words: Indocyanine green fluorescence imaging; laparoscopic hepatectomy; anatomic hepatectomy

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