在腹腔镜胆囊切除术期间使用氨酸绿色识别血管胆道解剖学:一项前性观察研究-IVA绿色研究
Angelo Christopher1, Srujan Lam Sharma2, Pranay Gaikwad3
1General Surgery Unit I, Christian Medical College, Vellore, 632 004, India.
概括
接近红外的光与绿 (ICG) 安全地识别了腹腔镜胆囊切除术期间的囊性导管和动脉解剖. 这种技术增强了可视化,有助于安全解剖,并可能防止胆道损伤.
科学领域:
- 手术创新 在外科创新.
- 医疗成像医学成像
- 胃肠病学 胃肠病学
背景情况:
- 腹腔镜胆囊切除术需要精确识别囊管和动脉解剖学.
- 血管胆道结构的异常会增加并发症的风险,包括胆道损伤.
- 近红外光为手术内解剖可视化提供了一个潜在的工具.
研究的目的:
- 评估印素绿 (ICG) 近红外光的可行性和有效性,用于在腹腔镜胆囊切除术期间识别囊性通道和动脉解剖.
- 评估该技术检测解剖学变异的能力.
- 分析影响这些结构可视化的因素.
主要方法:
- 对67名接受腹腔镜胆囊切除术的成年患者进行前性观察性研究.
- 在手术前6-10小时内给药绿色氨酸 (0.2 mg/kg).
- 使用近红外光成像对囊性通道,普通胆管 (CBD) 和囊性动脉的可视化进行评估.
- 统计分析以将人口因素 (性别,BMI) 与可视化成功相关联.
主要成果:
- 高可视化率:囊性管道 (88%),CBD (92.6%),囊性动脉 (85%).
- 组II变异是观察到的最常见的解剖变异.
- 在男性患者中,囊管的可视化更具挑战性.
- 在BMI>25 kg/m2的患者中,囊性动脉可视化减少.
结论:
- 印ocyanine绿色近红外光是一种安全,可行的,有效的辅助可视化血管胆道解剖在腹腔镜胆囊切除术.
- 该技术有助于预防胆道损伤,并支持安全的手术剖析.
- 在正常BMI的患者中,ICG光特别有益,并且是手术内胆血管学有前途的补充.
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