腹腔镜解剖性肝段切除术中吲哚菁绿荧光染色方法选择和术中超声应用策略

Strategy of indocyanine green fluorescence staining and ultrasound application in laparoscopic anatomical liver segmentectomy

随着对肝脏解剖认识的深入以及荧光腹腔镜设备的使用,腹腔镜解剖性肝切除术已成为治疗肝癌的首选手术方式,取得了良好的近远期疗效。吲哚菁绿荧光染色和术中超声检查是目前腹腔镜解剖性肝切除术中实时影像学引导最常用的两种技术手段,尤其对于肝段间立体界面的标定和引导肝实质离断尤为重要。笔者回溯国内外最新研究进展,结合临床实践对腹腔镜解剖性肝段切除术中吲哚菁绿荧光染色方法的选择和术中超声的应用进行阐述。

With the deeper understanding of liver anatomy and the use of fluorescent laparoscopic equipment,laparoscopic anatomical liver resection has become the first choice for the treatment of liver cancer,and achieved good short‐term and long‐term results.Indocyanine green(ICG)fluorescence staining and intraoperative ultrasound are the two most commonly used techniques for real‐time imaging guidance in laparoscopic anatomical liver resection,especially for the identification of three‐dimensional interface between liver segments and the guidance of hepatic parenchyma dissection.Based on latest research progress,and combined with clinical practice,the authors elaborate on the selection of ICG fluorescence staining method and the application of intraoperative ultrasound in laparoscopic anatomical liver segmentectomy.