Xu Jingyi, Qian Xinye, Yang Wei, Yu Fei, Yang Yufan, Hu Wang, Gao Lu, Wang Shuang, Wu Liusheng, Zhao Yutong, Yang Lei, Zhang Lin, Yan Jun
Center of Hepatobiliary Pancreatic Disease, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China.
Department of General Surgery, The First People's Hospital of Shuangliu District, West China (Airport) Hospital Sichuan University, Chengdu, China.
Front Med (Lausanne). 2024 Nov 5;11:1470120. doi: 10.3389/fmed.2024.1470120. eCollection 2024.
Hepatolithiasis is regarded as the presence of stones in the intrahepatic bile ducts. Recurrent inflammation of bile ducts can bring many bad effects. How to completely remove stones is still a challenge.
A 66-year-old male went to our hospital because of hepatolithiasis and choledocholithiasis. Selective hepatic arteriography and transcatheter arterial embolization followed by laparoscopic watershed hepatectomy under fluorescent navigation and laparoscopic common bile duct exploration on mass removal are performed.
For patients who suffer from hepatolithiasis, the main treatment principles of the operation are to remove the stones, correct the stenosis, and prevent recurrence. The laparoscopic watershed hepatectomy under fluorescent navigation can provide important support for precision liver surgery, which can give some suggestions for future hepatectomy.
Based on the three-dimensional (3D) visual watershed analysis, trans-arterial DSA positive fluorescence navigation has some advantages, which successfully overcome the shortcomings of the reverse staining method and the positive staining method.
肝内胆管结石是指肝内胆管存在结石。胆管反复炎症会带来诸多不良影响。如何彻底清除结石仍是一项挑战。
一名66岁男性因肝内胆管结石和胆总管结石前来我院就诊。先行选择性肝动脉造影及经导管动脉栓塞术,随后在荧光导航下行腹腔镜分水岭肝切除术,并在取石时行腹腔镜胆总管探查术。
对于肝内胆管结石患者,手术的主要治疗原则是清除结石、纠正狭窄并预防复发。荧光导航下的腹腔镜分水岭肝切除术可为精准肝脏手术提供重要支持,可为未来肝切除术提供一些参考。
基于三维(3D)视觉分水岭分析,经动脉数字减影血管造影(DSA)阳性荧光导航具有一些优势,成功克服了逆染法和正染法的缺点。