小児の腹腔鏡によるコレシステクトミーにおける短時間静脈内インドシアニン緑の投与:可視化と安全性の見通し評価
Vojtech Dotlacil1, Eliska Pajerova2, Dagmar Sovadinova2
1Department of Paediatric Surgery, Second Faculty of Medicine, Charles University and Motol University Hospital, Charles University, V Uvalu 84, Praha 5, 150 06, Prague, Czech Republic. vojtech.dotlacil@fnmotol.cz.
Pediatric surgery international
|August 26, 2025
まとめ
小児の腹腔鏡による胆管切除では,インドシアニングリーン (ICG) の短期投与は安全で有効です. この方法では 合併症のない高品質のイメージングが可能で 手術の安全性が向上します
科学分野:
- 小児外科
- 外科 画像 検査
- 胃腸内科
背景:
- インドシアニン緑色 (ICG) 光画像は小児腹腔鏡胆管切除 (LC) で胆管の可視化に役立ちます.
- 標準的なICG投与プロトコル (手術前16~24時間) は,小児のLCでは不適切である可能性があります.
- ICGのタイミングを最適化することは,手術中の胆管の解剖学的識別を強化し,胆管の損傷を防ぐために重要です.
研究 の 目的:
- 短期間のインドシアニングリーン (ICG) 投与の安全性と有効性を評価する.
- 小児のLCにおける胆道視覚化の強化のために,静脈内投与のVerdye®の使用の可能性を評価する.
- 術前のICG投与間隔の短縮が手術の結果や合併症発生率に影響するかどうかを判断する.
主な方法:
- Verdye®を静脈内投与する小児LC患者を対象とした単一センター研究.
- Likert,HELPFUL,そしてDISTURBEDスコアを用いて肝臓外胆管の解剖学的評価を行う.
- データ収集にはICGのタイミング,手術時間,合併症 (Clavien-Dindo分類) が含まれていた.
主要な成果:
- 11人の小児患者 (64% 女性,平均年齢14歳) が対象となった.
- ICGは手術前に平均225分投与され,その中位量は0. 34mg/ kgであった.
- 高品質の胆管可視化 (リッカースコア平均5) が達成され,ICG関連またはクラヴィエン・ディンド症候群の合併症はなかった.
結論:
- 短期間のICG投与は,小児性LCに対する安全で実行可能なアプローチです.
- この方法は胆管の可視化を効果的に促進し,胆管の損傷を予防するのに役立ちます.
- 短い間隔のプロトコルはよく許容され,高品質の手術中のイメージングを提供しました.
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