BACKGROUND Duodenum-preserving pancreatic head resection(DPPHR)is the choice of surgery for benign or low-grade malignant tumors of the pancreatic head.Laparoscopic DPPHR(LDPPHR)procedure can be improved by preoperati...BACKGROUND Duodenum-preserving pancreatic head resection(DPPHR)is the choice of surgery for benign or low-grade malignant tumors of the pancreatic head.Laparoscopic DPPHR(LDPPHR)procedure can be improved by preoperative 3D model reconstruction and the use of intravenous indocyanine green fluorescent before surgery for real-time navigation with fluorescent display to guide the surgical dissection and prevention of from injury to vessels and biliary tract.CASE SUMMARY Here we report the successful short-and long-term outcomes after one year following LDPPHR for a 60-year lady who had an uneventful recovery and was discharged home one week after the surgery.CONCLUSION There was no bile leakage or pancreatic leakage or delayed gastric emptying.The histopathology report showed multiple cysts in the pancreatic head and localized pancreatic intraepithelial tumor lesions.The resected margin was free of tumor.展开更多
The most common treatment of spontaneous tumor rupture hemorrhage(STRH)is transcatheter arterial embolization(TAE)followed by liver resection,and surgical navigation using near-infrared fluorescence is effective metho...The most common treatment of spontaneous tumor rupture hemorrhage(STRH)is transcatheter arterial embolization(TAE)followed by liver resection,and surgical navigation using near-infrared fluorescence is effective method for detecting hidden lesions and ill-defined tumor boundaries.However,due to the blockage of the tumor-supplying artery after effective TAE treatment,it is difficult to deliver sufficient fluorescent probes to the tumor region.In this study,we report on the successful application of superstable homogeneous intermixed formulation technology(SHIFT)in precise conversion hepatectomy for ruptured hepatocellular carcinoma(HCC).A homogeneous lipiodol-ICG formulation obtained by SHIFT(SHIFT-ICG)was developed for clinical practice for STRH.A ruptured HCC patient received the combined protocol for embolization and fluorescence surgical navigation and exhibited excellent hemostatic effect.Lipiodol and ICG were both effectively deposited in the primary lesion,including a small metastatic lesion.In follow-up laparoscopic hepatectomy,SHIFT-ICG could clearly and precisely image the full tumor regions and boundaries in real time,and even indistinguishable satellite lesions still expressed a remarkable fluorescence intensity.In conclusion,the simple and green SHIFT-ICG formulation can be effectively used in emergency embolization hemostasis and later precise fluorescence navigation hepatectomy in patients with ruptured HCC bleeding and has high clinical application value.展开更多
文摘BACKGROUND Duodenum-preserving pancreatic head resection(DPPHR)is the choice of surgery for benign or low-grade malignant tumors of the pancreatic head.Laparoscopic DPPHR(LDPPHR)procedure can be improved by preoperative 3D model reconstruction and the use of intravenous indocyanine green fluorescent before surgery for real-time navigation with fluorescent display to guide the surgical dissection and prevention of from injury to vessels and biliary tract.CASE SUMMARY Here we report the successful short-and long-term outcomes after one year following LDPPHR for a 60-year lady who had an uneventful recovery and was discharged home one week after the surgery.CONCLUSION There was no bile leakage or pancreatic leakage or delayed gastric emptying.The histopathology report showed multiple cysts in the pancreatic head and localized pancreatic intraepithelial tumor lesions.The resected margin was free of tumor.
基金supported by the National Key R&D Program of China(2019YFA0110600).
文摘The most common treatment of spontaneous tumor rupture hemorrhage(STRH)is transcatheter arterial embolization(TAE)followed by liver resection,and surgical navigation using near-infrared fluorescence is effective method for detecting hidden lesions and ill-defined tumor boundaries.However,due to the blockage of the tumor-supplying artery after effective TAE treatment,it is difficult to deliver sufficient fluorescent probes to the tumor region.In this study,we report on the successful application of superstable homogeneous intermixed formulation technology(SHIFT)in precise conversion hepatectomy for ruptured hepatocellular carcinoma(HCC).A homogeneous lipiodol-ICG formulation obtained by SHIFT(SHIFT-ICG)was developed for clinical practice for STRH.A ruptured HCC patient received the combined protocol for embolization and fluorescence surgical navigation and exhibited excellent hemostatic effect.Lipiodol and ICG were both effectively deposited in the primary lesion,including a small metastatic lesion.In follow-up laparoscopic hepatectomy,SHIFT-ICG could clearly and precisely image the full tumor regions and boundaries in real time,and even indistinguishable satellite lesions still expressed a remarkable fluorescence intensity.In conclusion,the simple and green SHIFT-ICG formulation can be effectively used in emergency embolization hemostasis and later precise fluorescence navigation hepatectomy in patients with ruptured HCC bleeding and has high clinical application value.
