Department of Neonatal Surgery, Neonatal Center, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, Beijing 100045, China.
Key Laboratory of Molecular Imaging, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190 China.
Photodiagnosis Photodyn Ther. 2022 Jun;38:102842. doi: 10.1016/j.pdpdt.2022.102842. Epub 2022 Apr 6.
A duodenal web refers to partial or complete obstruction of the duodenum due to a membranous web. When looking at the serosal side of the intestine during duodenal web excision, especially during laparoscopic surgery, determining the web origin might be challenging. This study aimed to determine the efficacy of intraduodenum indocyanine green injection and near-infrared light during laparoscopic surgery in enhancing the ability to identify duodenal web localization.
We used intraduodenum indocyanine green injection to unequivocally recognize the duodenal web and facilitate laparoscopic excision. The clinical analysis was based on a male neonatal case with duodenal web admitted to our hospital. After the patient was placed in the supine position, 5 mL of ICG was injected via a 6-Fr nasogastric tube. The fluorescence was visualized in the white light and near-infrared light dual-mode of the camera system, localizing the duodenal precisely and in real-time.
Laparoscopically, the duodenal web was accurately identified and removed with intraduodenum indocyanine green visualization under near-infrared light. The procedure was completed successfully, and the patient showed good postoperative outcomes.
Intraduodenum indocyanine green injection during laparoscopic surgery is a feasible adjuvant for duodenal web localization, showing improvements in terms of outcomes compared to previous methods of determining the duodenal web location.
十二指肠隔膜是指肠因膜性隔膜而导致部分或完全阻塞。在进行十二指肠隔膜切除术时，尤其是在腹腔镜手术中，观察肠浆膜侧时，确定隔膜起源可能具有挑战性。本研究旨在确定腹腔镜手术中十二指肠内吲哚菁绿注射和近红外光在增强识别十二指肠隔膜定位能力方面的效果。
我们使用十二指肠内吲哚菁绿注射来明确识别十二指肠隔膜，并有助于腹腔镜切除。该临床分析基于一名因十二指肠隔膜而入院的男性新生儿病例。患者取仰卧位，经 6Fr 鼻胃管注入 5mLICG。通过摄像系统的白光和近红外光双模可视化荧光，实时、精确地定位十二指肠。
腹腔镜下，在近红外光下通过十二指肠内吲哚菁绿可视化准确识别并切除了十二指肠隔膜。手术过程顺利，患者术后恢复良好。
腹腔镜手术中十二指肠内吲哚菁绿注射是一种可行的十二指肠隔膜定位辅助方法，与之前确定十二指肠隔膜位置的方法相比，在结果方面有所改善。
