Pesce Antonio, Latteri Saverio, Barchitta Martina, Portale Teresa R, Di Stefano Biagio, Agodi Antonella, Russello Domenico, Puleo Stefano, La Greca Gaetano
Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", University of Catania, Via S. Sofia 84, 95123 Catania, Italy.
Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", University of Catania, Via S. Sofia 84, 95123 Catania, Italy.
HPB (Oxford). 2018 Jun;20(6):538-545. doi: 10.1016/j.hpb.2017.11.013. Epub 2017 Dec 29.
The purpose was to evaluate the efficacy of near-infrared fluorescent cholangiography (FC) in real-time visualization of the biliary tree during elective laparoscopic cholecystectomy.
Fifty consecutive elective laparoscopic cholecystectomies were performed with fluorescent cholangiography. FC was performed at three time points: following exposure of Calot's triangle, prior to any dissection; and after partial and complete dissection of Calot's triangle.
The cystic duct (CD) was identified successfully by FC in 43 of 50 patients (86%) and in 45 of 50 patients (90%) before and after Calot's dissection respectively (p > 0.05). The common hepatic duct (CHD) and the common bile duct (CBD) were identified successfully in 12 of 50 patients (24%) and in 33 of 50 patients (66%) before Calot's dissection respectively and in 26 of 50 patients (52%) and in 47 of 50 patients (94%) after complete Calot's dissection (p = 0.007 and p = 0.001, respectively). Significant differences were observed for CBD visualization rate, in relation to BMI after Calot's dissection (p < 0.05) and history of cholecystitis, before Calot's dissection (p = 0.017). No bile duct injuries were reported.
Fluorescent cholangiography can be considered as a useful tool for intra-operative visualization of the biliary tree during laparoscopic cholecystectomies.
目的是评估近红外荧光胆管造影（FC）在择期腹腔镜胆囊切除术中实时显示胆管树的疗效。
连续对50例患者进行荧光胆管造影的择期腹腔镜胆囊切除术。FC在三个时间点进行：暴露胆囊三角后，在任何解剖操作之前；以及在胆囊三角部分和完全解剖之后。
50例患者中，43例（86%）在FC下成功识别出胆囊管（CD），在胆囊三角解剖前后分别有45例（90%）患者成功识别出胆囊管（p>0.05）。在胆囊三角解剖前，50例患者中分别有12例（24%）和33例（66%）成功识别出肝总管（CHD）和胆总管（CBD）；在胆囊三角完全解剖后，50例患者中分别有26例（52%）和47例（94%）成功识别出肝总管和胆总管（p分别为0.007和0.001）。在胆囊三角解剖后，观察到胆总管可视化率与BMI有关存在显著差异（p<0.05），在胆囊三角解剖前，与胆囊炎病史有关存在显著差异（p=0.017）。未报告胆管损伤。
荧光胆管造影可被视为腹腔镜胆囊切除术中术中显示胆管树的有用工具。
