Lin Hsing-Ying, Huang Chen-Han, Shy Shannon, Chang Yu-Chung, Chui Hsiang-Chen, Yu Tsung-Chih, Chang Chih-Han
Institute of Biomedical Engineering, National Cheng Kung University, Tainan 701, Taiwan ; Center for Nano Bio-detection, National Chung Cheng University, Chiayi 621, Taiwan ; These authors contributed equally to this work.
Biomed Opt Express. 2012 Sep 1;3(9):1964-71. doi: 10.1364/BOE.3.001964. Epub 2012 Jul 31.
Bile duct injury (BDI) is the most serious iatrogenic complication during laparoscopic cholecystectomy (LC) and occurs easily in inexperienced surgeons since the position of common bile duct (CBD) and its related ductal junctions are hard to precisely identify in the hepatic anatomy during surgery. BDI can be devastating, leading to chronic morbidity, high mortality, and prolonged hospitalization. In addition, it is the most frequent injury resulting in litigation and the most likely injury associated with a successful medical malpractice claim against surgeons. This study introduces a novel method for conveniently and rapidly indicating the anatomical location of CBD during LC by the direct fiber-optic illumination of 532-nm diode-pumped solid state laser through a microstructured plastic optical fiber to avoid the wrong identification of CBD and the injury from mistakenly cutting the CBD that can lead to permanent and even life threatening consequences. Six porcine were used for preliminary intra-CBD illumination experiments via laparotomy and direct duodenal incision to insert the invented CBD illumination laser catheter with nonharmful but satisfactory visual optical density.
胆管损伤（BDI）是腹腔镜胆囊切除术（LC）期间最严重的医源性并发症，在经验不足的外科医生中很容易发生，因为在手术过程中，肝部解剖结构中胆总管（CBD）及其相关的导管连接处很难精确识别。BDI可能具有毁灭性，会导致慢性发病、高死亡率和住院时间延长。此外，它是导致诉讼最频繁的损伤，也是最有可能与针对外科医生的成功医疗事故索赔相关的损伤。本研究介绍了一种新颖的方法，通过532纳米二极管泵浦固体激光器经微结构塑料光纤进行直接光纤照明，在LC期间方便快捷地指示CBD的解剖位置，以避免错误识别CBD以及误切CBD造成的损伤，这种损伤可能导致永久性甚至危及生命的后果。使用六头猪通过剖腹术和直接十二指肠切开术进行初步的CBD内照明实验，以插入具有无害但令人满意的视觉光密度的发明的CBD照明激光导管。
