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一种使用荧光素钠可视化肝胆结构的新型荧光成像技术:在大鼠模型中的临床前研究结果。

A new fluorescence imaging technique for visualizing hepatobiliary structures using sodium fluorescein: result of a preclinical study in a rat model.

机构信息

Department of Surgery, Korea University College of Medicine, Seoul, South Korea.

Department of Surgery, Korea University Medical Center Ansan Hospital, Ansan, Gyeonggi-do, South Korea.

出版信息

Surg Endosc. 2018 Apr;32(4):2076-2083. doi: 10.1007/s00464-017-5904-3. Epub 2017 Oct 24.

DOI:10.1007/s00464-017-5904-3
PMID:29067576
Abstract

BACKGROUND

Near-infrared fluorescence imaging has been recently applied in the field of hepatobiliary surgery. Our objective was to apply blue light fluorescence imaging to cholangiography and liver mapping during laparoscopic surgery. Therefore, we designed a preclinical study to evaluate the feasibility of using blue light fluorescence for cholangiography and liver mapping in a rat model.

METHODS

Sodium fluorescein solution (1 mL to each individual) were administered intravenously to 20 male Sprague-Dawley rats (6 weeks old, 200-250 g), after laparotomy. Whole abdominal organs were observed under blue light (at a wavelength of 440-490 nm) emitted from a commercialized LED curing light.

RESULTS

Immediately after the tracer solution was administered into the circulatory system of the rat, it was possible to visualize the location of the kidneys and the bile duct under blue light emitted from the light source. The liver was vaguely stained green by the tracer, while the ureters were not. After establishing biliary retention via duct clamping in the left lateral segment of the liver, the green color of the segment became distinct by the tracer, which showed vague coloration following release of the clamp.

CONCLUSION

We established the preclinical basis for using blue light fluorescence cholangiography and liver mapping in this study. The clinical feasibility of these techniques during laparoscopic cholecystectomy and hepatectomy remained to be demonstrated.

摘要

背景

近红外荧光成像是最近应用于肝胆外科领域的一种技术。我们的目的是将蓝光荧光成像应用于腹腔镜手术中的胆管造影和肝脏绘图。因此,我们设计了一项临床前研究,以评估在大鼠模型中使用蓝光荧光进行胆管造影和肝脏绘图的可行性。

方法

20 只雄性 Sprague-Dawley 大鼠(6 周龄,200-250g)行剖腹手术后,经静脉给予荧光素钠溶液(每只 1mL)。使用商业化的 LED 光固化灯发出的波长为 440-490nm 的蓝光观察整个腹部器官。

结果

在将示踪剂溶液注入大鼠循环系统后,立即可以在光源发出的蓝光下观察到肾脏和胆管的位置。肝脏被示踪剂染成绿色,而输尿管没有。在通过夹闭肝左外侧段胆管建立胆汁潴留后,该段的绿色因示踪剂而变得明显,夹闭释放后颜色变得模糊。

结论

本研究为蓝光荧光胆管造影和肝脏绘图的临床前基础奠定了基础。这些技术在腹腔镜胆囊切除术和肝切除术期间的临床可行性仍有待证明。

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J Laparoendosc Adv Surg Tech A. 2017 Aug;27(8):818-822. doi: 10.1089/lap.2016.0377. Epub 2016 Oct 19.
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Laparoscopic Anatomic Segment 6 Liver Resection Using the Glissonian Approach.采用肝蒂入路的腹腔镜解剖性肝Ⅵ段切除术
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Three-Dimensional Laparoscopic Anatomical Segment 8 Liver Resection with Glissonian Approach.
肝细胞癌(HCC)的创新疗法。
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三维腹腔镜下采用Glissonian入路行肝8段解剖性切除术
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Near-infrared fluorescence cholangiography assisted laparoscopic cholecystectomy versus conventional laparoscopic cholecystectomy (FALCON trial): study protocol for a multicentre randomised controlled trial.近红外荧光胆管造影辅助腹腔镜胆囊切除术与传统腹腔镜胆囊切除术(FALCON试验):一项多中心随机对照试验的研究方案
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Clinical application of indocyanine green-fluorescence imaging during hepatectomy.吲哚菁绿荧光成像在肝切除术中的临床应用
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Near-infrared cholecysto-cholangiography with indocyanine green may secure cholecystectomy in difficult clinical situations: proof of the concept in a porcine model.使用吲哚菁绿的近红外胆囊胆管造影术可能在困难临床情况下确保胆囊切除术的成功:猪模型中的概念验证
Surg Endosc. 2016 Sep;30(9):4115-23. doi: 10.1007/s00464-015-4608-9. Epub 2015 Oct 28.