Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
J Surg Oncol. 2020 Aug;122(2):226-233. doi: 10.1002/jso.25940. Epub 2020 May 20.
Recently, PINPOINT, a novel laparoscopic fusion indocyanine green fluorescence imaging (IGFI) system has become available for laparoscopic liver resection. This study aims to characterize fluorescence patterns of intrahepatic cholangiocarcinoma (ICC) using the negative counterstaining method in laparoscopic anatomical hepatectomies of ICC.
Eleven consecutive patients, diagnosed with intrahepatic cholangiocarcinoma and underwent laparoscopic liver resection between April 2017 and December 2018, were retrospectively reviewed. A laparoscopic IGFI navigation system was used to characterize fluorescence patterns of ICC with intraoperative liver segment demarcation by means of negative counterstaining.
Fusion IGFI of ICC was successfully obtained from all 11 patients from the surgical specimens. The fluorescence patterns of ICC can be categorized into rim-type fluorescence and segmental fluorescence, depending on tumor growth. In eight patients, indocyanine green fluorescence imaging was used to identify the hepatic lobes or segments by negative counterstaining. In six cases, a valid and persistent demarcation was achieved intraoperatively.
Laparoscopic IGFI system could identify different types of ICC lesions and may facilitate real-time navigation for laparoscopic anatomic liver resection of ICC.
最近，一种新型的腹腔镜融合吲哚菁绿荧光成像（IGFI）系统已可用于腹腔镜肝切除术。本研究旨在通过腹腔镜解剖性肝切除术对肝内胆管癌（ICC）采用负染法对其荧光模式进行特征描述。
回顾性分析了 2017 年 4 月至 2018 年 12 月连续 11 例经诊断为肝内胆管癌并接受腹腔镜肝切除术的患者。采用腹腔镜 IGFI 导航系统，通过术中肝脏节段负染对 ICC 进行荧光模式特征描述。
从 11 例患者的手术标本中均成功获得了 ICC 的融合 IGFI。根据肿瘤生长情况，ICC 的荧光模式可分为边缘型荧光和节段型荧光。在 8 例患者中，通过负染来识别肝叶或肝段的吲哚菁绿荧光成像。在 6 例病例中，术中实现了有效的、持续的边界定位。
腹腔镜 IGFI 系统可识别不同类型的 ICC 病变，并可能有助于 ICC 腹腔镜解剖性肝切除术的实时导航。
