吲哚菁绿荧光导航技术在腹腔镜肝胆胰外科手术中的研究进展

Research progress of indocyanine green fluorescent navigation technique in laparoscopic hepatobiliary and pancreatic surgery

近年来,随着吲哚菁绿(ICG)荧光导航技术在医学各个领域应用的日益广泛,该技术也越来越成熟,尤其是在腹腔镜肝胆胰外科手术中的发展日趋完善。ICG在肝脏外科手术中的应用主要包括界定肝肿瘤病灶边界、侦查微小病灶、检测切缘残留病灶、实时标记肝段和手术切肝平面,有效减低手术风险并提高R0切除率;在胆道外科中主要涉及肝内胆管癌、胆囊切除,识别术中胆汁漏,避免胆管损伤,降低术后并发症的发生率。ICG显像联合腹腔镜胰十二指肠切除术可精准判断胰腺肿瘤与血管的解剖位置关系、定位淋巴结转移等,为外科医生提供非常有用的实时视觉信息。笔者现就ICG联合腹腔镜技术在肝胆胰外科手术中的应用进行综述。

In recent years, with the increasingly wide application of indocyanine green(ICG) fluorescence navigation technique in various medical fields, it has grown more mature, especially its development in laparoscopic hepatobiliary and pancreatic surgery. The application of ICG in liver surgery mainly includes defining the boundaries of liver tumor lesions, discovering small lesions, detecting residual lesions at the resection margin, real-time marking of liver segments and surgical liver planes, which is beneficial to reduce the risk of surgery and improve the R0 resection rate;in biliary tract surgery mainly involves the resection of the intrahepatic cholangiocarcinoma and gallbladder, identifying intraoperative bile leakage, avoiding bile duct damage, and reducing the incidence of postoperative complications. ICG imaging combined with laparoscopic pancreaticoduodenectomy(LPD) can accurately determine the anatomical positional relationship between pancreatic tumors and blood vessels, and locate lymph node metastasis during surgery, providing surgeons with beneficial real-time visual information. Here, the authors summarize the application of ICG combined with laparoscopic techenique in hepatobiliary and pancreatic surgery.