腹部外科2024,Vol.37Issue(3) :190-194.DOI:10.3969/j.issn.1003-5591.2024.03.007

三维可视化、荧光影像联合术中超声在腹腔镜解剖性肝切除术中的应用

Application efficacy of three-dimensional visualization technology,fluorescent imaging system and intraoperative ultrasound for laparoscopic anatomical liver resection

杜秋国 李凯 张日新 郑小林 吴鑫华 翁方泽 朱岭
腹部外科2024,Vol.37Issue(3) :190-194.DOI:10.3969/j.issn.1003-5591.2024.03.007

三维可视化、荧光影像联合术中超声在腹腔镜解剖性肝切除术中的应用

Application efficacy of three-dimensional visualization technology,fluorescent imaging system and intraoperative ultrasound for laparoscopic anatomical liver resection

杜秋国 1李凯 1张日新 1郑小林 1吴鑫华 1翁方泽 1朱岭1
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作者信息

  • 1. 华中科技大学同济医学院附属武汉中心医院肝胆胰外科二科,湖北武汉 430014
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摘要

目的 分析三维可视化、荧光影像联合术中超声在针对原发性肝癌的腹腔镜解剖性肝切除术中的应用效果.方法 回顾性分析武汉市中心医院肝胆胰外科2023年1月至2023年12月期间行腹腔镜解剖性肝切除的22例原发性肝癌病人的临床资料.术前通过专业软件建立肝脏三维可视化模型并规划手术路径,术中通过荧光影像技术和术中超声的导航,进行解剖性肝切除.结果 22例病人均按术前规划顺利完成手术.21例病人吲哚菁绿染色均成功,有1例因肝硬化严重而导致肿瘤吲哚菁绿染色未成功,但亦通过术中超声顺利完成解剖性肝切除.病理结果:肝细胞癌20例,胆管细胞癌1例,混合型肝癌1例;切缘均为阴性.病人术后恢复良好,顺利出院.随访2~8个月未见肿瘤复发.结论 三维可视化、吲哚菁绿荧光影像联合术中超声对进行腹腔镜解剖性肝切除术提供了坚实的基础.

Abstract

Objective To summarize the experiences of laparoscopic anatomical liver resection through a combination of three-dimensional 3D visualization technology,fluorescent imaging system and Intraoperative ultrasound.Methods From January 2023 to December 2023,the relevant clinical data were retrospectively reviewed for 22 patients of primary liver cancer undergoing laparoscopic anatomical liver resection.Before surgery,a three-dimensional visualization model of liver was established and surgical path planned.During surgery,anatomical liver resection was performed with fluorescent imaging technology and intraoperative ultrasound.Results All operations were successful on the basis of preoperative plan.Indocyanine green(ICG)stain was successful(n=21).One case of unsuccessful ICG stain was due to severe liver cirrhosis.The pathological diagnoses were hepatocellular carcinoma(n=20),cholangiocarcinoma(n=1)and mixed liver cancer(n=1).All margins were negative.All of them recovered well after surgery and were discharged uneventfully.There was no tumor recurrence during a postoperative follow-up period of(2-8)months.Conclusion A combination of 3D visualization,ICG fluorescent imaging and intraoperative ultrasound provides a solid foundation for laparoscopic anatomical liver resection.

关键词

原发性肝癌/腹腔镜/解剖性肝切除术/三维可视化/荧光影像/术中超声

Key words

Primary liver cancer/Laparoscope/Anatomical liver resection/Three-dimensional visualization/Fluorescent imaging/Intraoperative ultrasound

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出版年

2024
腹部外科
中华医学会武汉分会

腹部外科

CSTPCD
影响因子:0.615
ISSN:1003-5591
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