超声引导下应用压迫技术联合吲哚菁绿荧光成像的解剖性肝切除术。
Ultrasound-guided anatomical liver resection using a compression technique combined with indocyanine green fluorescence imaging.
机构信息
Division of Hepatobiliary & General Surgery, Department of Surgery, Humanitas Research Hospital - IRCCS, Humanitas University, Rozzano, MI, Italy.
Division of Hepatobiliary & General Surgery, Department of Surgery, Humanitas Research Hospital - IRCCS, Humanitas University, Rozzano, MI, Italy.
出版信息
HPB (Oxford). 2021 Feb;23(2):206-211. doi: 10.1016/j.hpb.2020.05.009. Epub 2020 Jun 18.
BACKGROUND
Anatomical resection (AR) is a recommended surgical treatment for hepatocellular carcinoma (HCC). However, the conventional procedure (dye injection) for AR is difficult to reproduce. As an alternative, the tumour-feeding portal pedicle compression technique (finger-compression technique) has been proposed as an easy and reversible procedure. Here, we propose a new method combining indocyanine green (ICG) imaging with the finger-compression technique.
METHODS
Eligible patients were prospectively enrolled to undergo ICG compression (ICG-C) anatomical hepatectomy for HCC.
RESULTS
Fifteen patients underwent AR using the ICG-C technique. Overall, the surgical procedures included six segmentectomies, seven subsegmentectomies, and two right posterior sectionectomies. The median tumour size was 5.8 cm (range 2-7 cm). All procedures had an R0 margin. There were no major complications among patients, and minor morbidity occurred in three patients.
CONCLUSIONS
ICG-C is a safe, feasible and effective technique for patients eligible for AR.
背景
解剖性肝切除术（AR）是推荐的肝细胞癌（HCC）的手术治疗方法。然而，AR 的常规方法（染料注射）很难重复。作为替代方法，肿瘤供养门静脉蒂压迫技术（手指压迫技术）已被提出作为一种简单且可逆转的方法。在这里，我们提出了一种将吲哚菁绿（ICG）成像与手指压迫技术相结合的新方法。
方法
符合条件的患者前瞻性地入组接受吲哚菁绿压迫（ICG-C）解剖性肝切除术治疗 HCC。
结果
15 名患者接受了 ICG-C 技术的 AR。总体而言，手术程序包括 6 次肝段切除术、7 次亚肝段切除术和 2 次右后叶段切除术。肿瘤大小中位数为 5.8cm（范围 2-7cm）。所有手术均达到 R0 切缘。患者中无重大并发症，3 例发生轻微并发症。
结论
ICG-C 是一种安全、可行和有效的技术，适用于适合 AR 的患者。
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