腹腔镜下穿刺正染技术在解剖性后上肝段切除术中的应用价值

Application value of laparoscopic ultrosound guided puncture and positive staining tech-nique in anatomical right superior segmentectomy

解剖性后上肝段切除术一直是腹腔镜肝切除术中难度较大的手术方式,如何准确判断肝段之间的界面,从而实现真正意义上的流域解剖性肝切除术是精准肝脏外科时代的新要求。门静脉穿刺荧光正染技术能有效解决此问题,其在解剖性后上肝段切除术中具有一系列优点,但同时也具有技术要求。吲哚菁绿荧光染色能够直观显示肝段流域的立体范围,是一种更精准的导航模式,有助于肝脏外科医师对后上肝段范围的识别,从而更加安全、规范地开展手术。笔者查阅相关研究,结合临床实践,探讨腹腔镜下穿刺正染技术在解剖性后上肝段切除术中的应用价值。

Anatomical right superior segmentectomy has always been a difficult surgical procedure in laparoscopic liver resection.How to accurately judge the interface between liver segments,so as to achieve a true sense of anatomic resection based on portal territory is a new requirement in the era of precision liver surgery.The portal vein puncture and indocyanine green(ICG)fluorescence positive staining technique can effectively solve this problem,which has a series of advantages and certain technical requirements in anatomical right superior segmentectomy.ICG fluorescence staining can intuitively define the three?dimensional range of the liver segment,which is a more accurate navigation mode that helps liver surgeons identify the range of the right superior liver segment,thus conducting surgery more safely and normatively.The authors consult relevant studies and combined with clinical practice to explore the application value of laparoscopic ultrosound guided puncture and positive staining technique in anatomical right superior segmentectomy.