吲哚菁绿荧光成像在腹腔镜胰腺癌手术中的应用分析
Application of indocyanine green fluorescence imaging in laparoscopic surgery for pancreatic cancer
奚士航 1王小明 1王冠男 1蒋亚琦 1钱道海 1方小三1
作者信息
- 1. 皖南医学院第一附属医院肝胆外科,芜湖 241001
- 折叠
摘要
目的 分析吲哚菁绿荧光成像在腹腔镜胰腺癌手术切除中的应用情况.方法 回顾分析皖南医学院第一附属医院肝胆外科2022年6月至2023年3月术前诊断为胰腺癌并行手术切除的15例患者资料,其中男性13例,女性2例,年龄(67.0±8.6)岁.15例患者均行腹腔镜手术切除,术中注射吲哚菁绿使病变显影,显影范围外手术切除.记录手术方式、病变病理类型、吲哚菁绿显影、手术切缘等情况.结果 15例患者中行腹腔镜胰十二指肠切除术7例,腹腔镜根治性顺行模块化胰脾切除术7例,1例为腹腔镜探查后中转开腹行胰十二指肠切除术,并联合肠系膜上静脉切除重建.术后病理证实为胰腺中分化腺癌9例,胰腺中低分化腺癌4例,胰腺腺泡细胞癌1例,胰腺炎性病变1例;所有肿瘤切缘阴性.15例患者中14例患者术中显影,1例未显影(系1例胰腺中分化腺癌).在显影的14例患者中,13例病理为胰腺癌,表现为肿瘤被膜显影,1例为炎性病变,表现为病灶实质显影.结论 腹腔镜手术术中注射吲哚菁绿能够使胰腺癌肿瘤被膜荧光显影,有利于肿瘤定位及判断切缘.
Abstract
Objective To analyze the application of indocyanine green(ICG)fluorescence imaging in laparoscopic resection of pancreatic cancer.Methods Data of 15 patients undergoing laparoscopic sur-gery for pancreatic cancer in the Department of Hepatobiliary Surgery of the First Affiliated Hospital of Wan-nan Medical College from June 2022 to March 2023 were retrospectively analyzed,including 13 males and 2 females,aged(67.0±8.6)years.ICG were intraoperatively injected to visualize the lesion and guide sur-gical resection.The surgical methods,postoperative pathology,ICG fluorescence imaging and tumor margins were reviewd.Results Among the patients,seven underwent laparoscopic pancreaticoduodenectomy,seven underwent laparoscopic radical antegrade modular pancreaticosplenectomy,and one conversed to open pan-creaticoduodenectomy due to combined superior mesenteric vein reconstruction.Postoperative pathology con-firmed pancreatic moderately differentiated adenocarcinoma in nine cases,pancreatic moderately-low differ-entiated adenocarcinoma in four cases,pancreatic follicular cell carcinoma in one case,and inflammatory lesion in one case.Negative surgical margins were confirmed in all cases.Pancreatic lesion were visualized in 14 cases(fluorescent delineation of the tumor capsule)but not well visualized in one case(with moder-ately differentiated adenocarcinoma).In the case of inflammatory disease,the lesion parenchyma were visu-alized.Conclusion ICG injection in laparoscopic surgery enables visualization of pancreatic tumor,which facilitates tumor localization and margin determination.
关键词
胰腺肿瘤/吲哚菁绿/荧光成像Key words
Pancreatic neoplasms/Indocyanine green/Fluorescence imaging引用本文复制引用
基金项目
安徽省高等学校自然科学研究项目(2023AH040254)
安徽省卫生健康科研项目(AHWJ2023A10151)
安徽省临床医学研究转化专项(202204295107020059)
出版年
2024
NETL
NSTL
万方数据