Mohsen Amr A, Elbasiouny Mahmoud S, Fawzy Yasser Sherif
Cairo University, Cairo, Egypt.
Surg Innov. 2013 Apr;20(2):105-8. doi: 10.1177/1553350612442794. Epub 2012 Apr 2.
Safe cholecystectomy requires confident identification of extrahepatic biliary anatomy. This is the first report of the use of fluorescein and ultraviolet light to improve visualization of biliary topography during laparoscopic cholecystectomy.
Five patients who had symptomatic gallstones underwent laparoscopic cholecystectomy with intraoperative intravenous fluorescein injection. Ultraviolet A from an LED light source was used to induce fluorescence of bile. It was delivered by a device that was designed and built by the authors.
Within 4 to 5 minutes the bile ducts were shining with green fluorescence and were easily differentiated from the surrounding tissues. In all cases, identification of the extrahepatic biliary anatomy by the fluorescence technique preceded its identification with conventional white light. Fluorescence remained for the whole duration of operation that extended for 42 to 77 minutes.
At laparoscopic cholecystectomy, intravenous fluorescein injection and ultraviolet A excitation induce bile ducts to fluoresce. The technique allows better and earlier real-time visualization of biliary anatomy than conventional white light. The technique is simple and inexpensive. It serves as an additional tool that would improve safety of laparoscopic cholecystectomy.
安全的胆囊切除术需要准确识别肝外胆道解剖结构。这是关于在腹腔镜胆囊切除术中使用荧光素和紫外线来改善胆道形态可视化的首份报告。
五名有症状胆结石患者接受了腹腔镜胆囊切除术，术中静脉注射荧光素。使用来自LED光源的紫外线A诱导胆汁产生荧光。它由作者设计和制造的设备进行传递。
在4至5分钟内，胆管发出绿色荧光，很容易与周围组织区分开来。在所有病例中，通过荧光技术识别肝外胆道解剖结构先于用传统白光进行的识别。荧光在长达42至77分钟的整个手术过程中一直存在。
在腹腔镜胆囊切除术中，静脉注射荧光素和紫外线A激发可使胆管发出荧光。该技术比传统白光能更好、更早地实时可视化胆道解剖结构。该技术简单且成本低廉。它是一种可提高腹腔镜胆囊切除术安全性的辅助工具。
