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山东大学学报 (医学版) ›› 2022, Vol. 60 ›› Issue (3): 83-88.doi: 10.6040/j.issn.1671-7554.0.2021.0996

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三维可视化联合吲哚菁绿荧光影像技术在51例原发性肝癌腹腔镜切除术中的应用价值

李博,刘竞芳,鲍金鹏,李祥泽,秦广洋,田虎   

  • 发布日期:2022-03-09
  • 通讯作者: 田虎. E-mail:tianhu6585@163.com
  • 基金资助:
    济南市临床医学科技创新计划(201805033)

Application value of three-dimensional visualization combined with indocyanine green fluorescence technique in laparoscopic hepatectomy in the treatment of 51 patients with primary liver cancer

LI Bo, LIU Jingfang, BAO Jinpeng, LI Xiangze, QIN Guangyang, TIAN Hu   

  1. Department of General Surgery, Shandong Provincial Hospital, Cheeloo College of Medicine Shandong University, Jinan 250014, Shandong, China
  • Published:2022-03-09

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摘要： 目的 探讨在原发性肝癌(PLC)腹腔镜切除术中应用三维可视化联合吲哚菁绿(ICG)荧光影像技术的优势。 方法 采用回顾性病例-对照研究方法收集2019年1月至2021年1月山东大学附属山东省千佛山医院收治的105例PLC患者临床资料,其中行三维可视化联合吲哚菁绿荧光影像技术原发性肝癌腹腔镜切除术51例(观察组),行常规原发性肝癌腹腔镜切除术54例(对照组)。收集基线资料、手术时间、肝门阻断时间、输血情况、住院天数、术后病理、并发症及术后第1、3、6个月随访资料,比较两组疗效、并发症的发生情况及术后短期复发情况。 结果 观察组手术时间［225(135)vs 282.5(118)min,Z=-2.687, P=0.007］、术中肝门阻断时间［(35.9±8.5)vs(240.7±6.8)min, t=-3.183,P=0.002］均短于对照组,术中失血量［300(200)vs 363(141)mL, Z=-2.621,P=0.009］低于对照组。观察组术后并发症［5(4.8%)vs 14(13.3%),χ2=-4.600,P=0.032］、术后第1天丙氨酸氨基转移酶［332.1(131.7)vs 386.2(100.0),Z=-2.379,P=0.017］、第3天丙氨酸氨基转移酶［(227.1±76.1)vs(274.8±74.0),t=-3.257,P=0.002］、第5天丙氨酸氨基转移酶［(114.4±51.7)vs(151.1±61.0),t=-3.254,P=0.001］均低于对照组。 结论 三维可视化联合吲哚菁绿荧光影像技术在腹腔镜原发性肝癌切除术在缩短手术时间、术中肝门阻断时间,减少手术失血、术后并发症及术后肝功能损害具有优势。体现出了精准肝切除的理念。

关键词: 三维可视化, 吲哚菁绿, 原发性肝癌, 腹腔镜肝切除术

Abstract: Objective To explore the advantages of three-dimensional visualization combined with indocyanine green(ICG)fluorescence imaging in laparoscopic liver resection of primary liver cancer(PLC). Methods A retrospective case-control study was conducted to involve 105 PCL patients treated during Jan. 2019 and Jan. 2021, including 51 cases treated with laparoscopic hepatectomy combined with ICG fluorescence imaging(observation group)and 54 cases treated with conventional laparoscopic hepatectomy resection of PLC(control group). The baseline data, operation time, hilar occlusion time, blood transfusion, hospital stay, postoperative pathology, complications and follow-up data at 1st, 3rd and 6th months after operation were collected. The curative effect, incidence of complications and short-term postoperative recurrence were compared between the two groups. Results The operation time ［225(135)vs 282.5(118)min, Z=-2.687, P=0.007］ and intraoperative portal occlusion time ［(35.9±8.5)vs(240.7±6.8)min, t=-3.183, P=0.002］ were shorter in the observation group than in the control group. The intraoperative bleeding volume ［300(200)vs 363(141)mL, Z=-2.621, P=0.009］, incidence of complications ［5(4.8%)vs 14(13.3%), χ2=-4.600, P=0.032］, and level of glutamic pyruvic transaminase(ALT)on day 1 ［332.1(131.7)vs 386.2(100.0), Z=-2.379, P=0.017］, day 3 ［(227.1±76.1)vs(274.8±74.0), t=-3.257, P=0.002］ and day 5 ［(114.4±51.7)vs(151.1±61.0), t=-3.254, P=0.001］ were lower in the observation group than in the control group. Conclusion Compared to the conventional laparoscopic liver resection, three-dimensional visualization combined with ICG fluorescence imaging technique has advantages of shorter operation time and intraoperative hepatic hilar occlusion time, less operative bleeding and liver function damage, and fewer postoperative complications, which best embodies the concept of precise hepatectomy.

Key words: Three-dimensional visualization, Indocyanine green, Primary liver cancer, Laparoscopic hepatectomy

中图分类号: 

  • R735.7
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