三維CT重建聯合吲哚菁綠顯影技術應用于腹腔鏡保留十二指腸胰頭切除術2例報道_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

張帥 ¹ , 費發珠 ¹ , 韓欣 ² , 王偉 ¹ , 邵藝超 ¹ , 楊新濤 ¹ , 王海久 ¹ ,  侯立朝 ¹

1. ;
2. ;

Corresponding?author：

侯立朝, Email: zhuoyue_1973@163.com

Keywords：

胰腺腫瘤; 腹腔鏡; 三維重建; 吲哚菁綠; 保留十二指腸胰頭切除術

DOI：

10.7507/1007-9424.202311023

Video：

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目的探討三維CT重建聯合吲哚菁綠顯影技術應用于腹腔鏡保留十二指腸胰頭切除術（laparoscopic duodenum-preserving pancreatic head resection，LDPPHR）相關經驗。方法回顧性分析青海大學附屬醫院2022年5月至2022年8月期間在三維CT重建聯合吲哚菁綠熒光導航下行LDPPHR 2例患者的臨床資料。結果 2例患者均順利完成LDPPHR，病例1和病例2的年齡分別為53和55歲，均為女性，手術時間分別為445 min和425 min，術中出血量分別為200 mL和250 mL，均使用了負壓沖洗引流管。病例2術后發生胰腺生化漏，經治療后均恢復正常。2例均未發生嚴重并發癥。病例1和病例2術后住院時間分別為12 d和25 d，術后病理學檢查結果提示病例1為胰腺漿液性囊腺瘤、病例2為胰腺真性上皮性囊腫。病例1和病例2術后隨訪時間分別為13個月和10個月，隨訪期間內均未出現胰腺內、外分泌功能障礙。結論三維CT重建聯合吲哚菁綠應用于LDPPHR是一種安全、有效的手術方式，能有效辨別術中膽管解剖結構，并能發現術中微小膽管損傷，避免術后膽汁漏的發生。

Citation： 張帥, 費發珠, 韓欣, 王偉, 邵藝超, 楊新濤, 王海久, 侯立朝. 三維CT重建聯合吲哚菁綠顯影技術應用于腹腔鏡保留十二指腸胰頭切除術2例報道. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2024, 31(7): 870-873. doi: 10.7507/1007-9424.202311023 Copy

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2.	Beger HG, Witte C, Krautzberger W, et al. Experiences with duodenum-sparing pancreas head resection in chronic pancreatitis. Chirurg, 1980, 51(5): 303-307.
3.	Beger HG, Siech M, Poch B. Duodenumerhaltende totale pankreaskopfresektion. Der Chirurg, 2013, 84(5): 412-420.
4.	李兆申, 金震東, 李汛. 中國胰腺囊性腫瘤診斷指南(2022年). 臨床肝膽病雜志, 2023, 39(2): 290-298.
5.	張太平, 羅文浩, 邱江東, 等. 對胰腺囊性腫瘤手術指征的再思考. 中華外科雜志, 2022, 60(7): 646-650.
6.	Diener MK, Hüttner FJ, Kieser M, et al. Partial pancrea-toduodenectomy versus duodenum-preserving pancreatic head resection in chronic pancreatitis: the multicentre, randomised, controlled, double-blind ChroPac trial. Lancet, 2017, 390(10099): 1027-1037.
7.	Takada T, Yasuda H, Amano H, et al. A duodenum-preserving and bile duct–preserving total pancreatic head resection with associated pancreatic duct-to-duct anastomosis. J Gastrointest Surg, 2004, 8(2): 220-224.
8.	Cai Y, Zheng Z, Gao P, et al. Laparoscopic duodenum-preserving total pancreatic head resection using real-time indocyanine green fluorescence imaging. Surg Endosc, 2021, 35(3): 1355-1361.
9.	范應方, 方馳華. 三維可視化技術在肝膽外科臨床應用的爭議與共識. 中國實用外科雜志, 2018, 38(2): 137-141.
10.	Inoue Y, Saiura A, Arita J, et al. Hepatic vein-oriented liver resection using fusion indocyanine green fluorescence imaging. Ann Surg, 2015, 262(6): e98-e99. doi: 10.1097/SLA.0000000000000833.
11.	Lu C, Xu B, Mou Y, et al. Laparoscopic duodenum-preserving pancreatic head resection with real-time indocyanine green guidance of different dosage and timing: enhanced safety with visualized biliary duct and its long-term metabolic morbidity. Langenbecks Arch Surg, 2022, 407(7): 2823-2832.
12.	Beger HG, Mayer B, Rau BM. Parenchyma-sparing, limited pancreatic head resection for benign tumors and low-risk periampullary cancer—a systematic review. J Gastrointest Surg, 2016, 20(1): 206-217.
13.	王強. 不同負壓引流模式對胰十二指腸切除術后并發癥的影響. 復旦大學, 2014.
14.	董家鴻, 楊世忠. 精準肝切除的技術特征與臨床應用. 中國實用外科雜志, 2010, 30(8): 638-640.
15.	Cao J, Li G, Wei J, et al. Laparoscopic duodenum-preserving total pancreatic head resection: a novel surgical approach for benign or low-grade malignant tumors. Surg Endosc, 2019, 33(2): 633-638.
16.	韓薔, 吳昊鈞, 陳利平. 三維重建及吲哚菁綠輔助下開展腹腔鏡保留十二指腸胰頭切除術1例報道. 中國普外基礎與臨床雜志, 2022, 29(9): 1160-1164.

1. Beger HG, Krautzberger W, Bittner R, et al. Duodenum-sparing pancreas head resection in chronic pancreatitis—results after 10 years’ use. Langenbecks Arch Chir, 1984, 362(4): 229-236.
2. Beger HG, Witte C, Krautzberger W, et al. Experiences with duodenum-sparing pancreas head resection in chronic pancreatitis. Chirurg, 1980, 51(5): 303-307.
3. Beger HG, Siech M, Poch B. Duodenumerhaltende totale pankreaskopfresektion. Der Chirurg, 2013, 84(5): 412-420.
4. 李兆申, 金震東, 李汛. 中國胰腺囊性腫瘤診斷指南(2022年). 臨床肝膽病雜志, 2023, 39(2): 290-298.
5. 張太平, 羅文浩, 邱江東, 等. 對胰腺囊性腫瘤手術指征的再思考. 中華外科雜志, 2022, 60(7): 646-650.
6. Diener MK, Hüttner FJ, Kieser M, et al. Partial pancrea-toduodenectomy versus duodenum-preserving pancreatic head resection in chronic pancreatitis: the multicentre, randomised, controlled, double-blind ChroPac trial. Lancet, 2017, 390(10099): 1027-1037.
7. Takada T, Yasuda H, Amano H, et al. A duodenum-preserving and bile duct–preserving total pancreatic head resection with associated pancreatic duct-to-duct anastomosis. J Gastrointest Surg, 2004, 8(2): 220-224.
8. Cai Y, Zheng Z, Gao P, et al. Laparoscopic duodenum-preserving total pancreatic head resection using real-time indocyanine green fluorescence imaging. Surg Endosc, 2021, 35(3): 1355-1361.
9. 范應方, 方馳華. 三維可視化技術在肝膽外科臨床應用的爭議與共識. 中國實用外科雜志, 2018, 38(2): 137-141.
10. Inoue Y, Saiura A, Arita J, et al. Hepatic vein-oriented liver resection using fusion indocyanine green fluorescence imaging. Ann Surg, 2015, 262(6): e98-e99. doi: 10.1097/SLA.0000000000000833.
11. Lu C, Xu B, Mou Y, et al. Laparoscopic duodenum-preserving pancreatic head resection with real-time indocyanine green guidance of different dosage and timing: enhanced safety with visualized biliary duct and its long-term metabolic morbidity. Langenbecks Arch Surg, 2022, 407(7): 2823-2832.
12. Beger HG, Mayer B, Rau BM. Parenchyma-sparing, limited pancreatic head resection for benign tumors and low-risk periampullary cancer—a systematic review. J Gastrointest Surg, 2016, 20(1): 206-217.
13. 王強. 不同負壓引流模式對胰十二指腸切除術后并發癥的影響. 復旦大學, 2014.
14. 董家鴻, 楊世忠. 精準肝切除的技術特征與臨床應用. 中國實用外科雜志, 2010, 30(8): 638-640.
15. Cao J, Li G, Wei J, et al. Laparoscopic duodenum-preserving total pancreatic head resection: a novel surgical approach for benign or low-grade malignant tumors. Surg Endosc, 2019, 33(2): 633-638.
16. 韓薔, 吳昊鈞, 陳利平. 三維重建及吲哚菁綠輔助下開展腹腔鏡保留十二指腸胰頭切除術1例報道. 中國普外基礎與臨床雜志, 2022, 29(9): 1160-1164.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

三維CT重建聯合吲哚菁綠顯影技術應用于腹腔鏡保留十二指腸胰頭切除術2例報道

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