Institute of Hepatobiliary Surgery of the Army, Southwest Hospital, Army Medical University, Chongqing, China.
Department of Hepatic-Biliary-Pancreatic Surgery, The First People's Hospital of Neijiang, Neijiang, Sichuan, China.
Ann Surg Oncol. 2024 Jun;31(6):4019-4021. doi: 10.1245/s10434-024-15161-8. Epub 2024 Mar 13.
Currently, an effective tracer technique for lymphatic drainage during laparoscopic surgery has not been established. This study aimed to elucidate a new fluorescence, imaging technique targeting the hepatic lymphatic drainage area, using indocyanine green (ICG).
A patient diagnosed with intrahepatic cholangiocarcinoma (ICC) located in segment 8 of the liver was injected with ICG into the connective tissue of the Glisson pedicle supplied by the lesion's liver segment, avoiding the bile duct, portal vein, and hepatic artery. This was performed under the guidance of laparoscopic ultrasonographic localization to trace the lymph nodes.
The lymphatic drainage area traced intraoperatively by ICG was consistent with the definition of the right regional lymph nodes for ICC. The lymph nodes were dissected, followed by addition of a fluorescence tracer.
Mastering intraoperative ultrasonic puncture technology can enable effective and accurate tracing of the lymph nodes of the liver segment where the lesion is located. However, the technical standards for this methodology need to be established through further studies.
目前，腹腔镜手术中尚未建立有效的淋巴引流示踪技术。本研究旨在使用吲哚菁绿（ICG）阐明一种针对肝淋巴引流区域的新荧光成像技术。
对一名诊断为位于肝脏 8 段的肝内胆管癌（ICC）的患者，在病变所在肝段的供应组织的 Glisson 蒂结缔组织内注入 ICG，避开胆管、门静脉和肝动脉。在腹腔镜超声定位的引导下进行，以追踪淋巴结。
ICG 术中追踪的淋巴引流区域与 ICC 的右区域淋巴结定义一致。对淋巴结进行解剖，然后加入荧光示踪剂。
掌握术中超声穿刺技术可以有效地准确追踪病变所在肝段的淋巴结。但是，需要通过进一步的研究来建立该方法的技术标准。
