The application of real-time indocyanine green fluorescence cholangiography in laparoscopic living donor left lateral sectionectomy.

IF 6.1 2区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Hepatobiliary surgery and nutrition Pub Date : 2024-08-01 Epub Date: 2024-01-05 DOI:10.21037/hbsn-23-288

Lu Lu, Wen-Wei Zhu, Cong-Huan Shen, Yi-Feng Tao, Zheng-Xin Wang, Jin-Hong Chen, Lun-Xiu Qin

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Abstract

Background: The judgment of the division point of the bile duct has always been one of the difficulties of laparoscopic left lateral sectionectomy (LLLS). The purpose of this study was to assess the effects of indocyanine green (ICG) fluorescence cholangiography during LLLS on the occurrence of biliary complications in both donors and recipients. The optimal dose and injection time of ICG were also investigated.

Methods: This is a retrospective cohort study. From October 2016 to December 2022, the clinical data of 103 donors who underwent LLLS and relevant recipients were retrospectively analyzed. According to whether ICG fluorescence cholangiography was used, they were divided into a non-ICG group (n=46) and an ICG group (n=57). Biliary complications were observed and the optimal dose and injection time of ICG were explored.

Results: Three donors in the non-ICG group suffered from bile leakage. Four grafts had multiple bile duct openings and biliary complications were observed in the relevant recipients who received these grafts in the non-ICG group. Two recipients had bile leakage, and the other two had biliary stenosis. There was no biliary complications both in donors and recipients in the ICG group. The fluorescence intensity of the liver was 108.1±17.6 at a dose of 0.004 mg/kg 90 minutes after injection, significantly weaker than that at 0.05 mg/kg 30 minutes (200.3±17.6, P=0.001) and 90 minutes after injection (140.2±15.4, P=0.001). The fluorescence intensity contrast value at a dose of 0.004 mg/kg was stronger than that at 0.05 mg/kg, both measured 90 minutes after injection (0.098±0.032 vs. 0.078±0.022, P=0.021).

Conclusions: ICG fluorescence cholangiography is safe and feasible in LLLS. It reduces biliary complications in both donors and recipients. The optimal ICG dose was 0.004 mg/kg, and 90 minutes after injection was the best observation time. ICG fluorescence cholangiography is recommended for routine use in LLLS.

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实时吲哚青绿荧光胆管造影在腹腔镜活体供体左侧切口切除术中的应用。

背景：胆管分割点的判断一直是腹腔镜左外侧切口切除术（LLLS）的难点之一。本研究旨在评估 LLLS 期间吲哚青绿（ICG）荧光胆管造影对供体和受体胆道并发症发生的影响。研究还探讨了 ICG 的最佳剂量和注射时间：这是一项回顾性队列研究。方法：这是一项回顾性队列研究。从 2016 年 10 月至 2022 年 12 月，对 103 例接受 LLLS 的供体和相关受体的临床资料进行了回顾性分析。根据是否使用ICG荧光胆管造影，将其分为非ICG组（n=46）和ICG组（n=57）。观察胆道并发症，探讨 ICG 的最佳剂量和注射时间：结果：非 ICG 组中有三名供体出现胆漏。结果：非 ICG 组中有 3 名供体出现胆漏，4 例移植物有多个胆管开口，非 ICG 组中接受这些移植物的相关受体出现了胆道并发症。其中两名受者出现胆漏，另外两名受者出现胆道狭窄。ICG 组的供体和受体均未出现胆道并发症。注射 0.004 mg/kg 剂量的 ICG 90 分钟后，肝脏的荧光强度为 108.1±17.6，明显弱于注射 0.05 mg/kg 剂量的 30 分钟后（200.3±17.6，P=0.001）和 90 分钟后（140.2±15.4，P=0.001）。在注射 90 分钟后测量的荧光强度对比值（0.098±0.032 vs. 0.078±0.022，P=0.021）中，剂量为 0.004 mg/kg 的荧光强度对比值强于剂量为 0.05 mg/kg 的荧光强度对比值：结论：ICG 荧光胆管造影在 LLLS 中安全可行。结论：ICG 荧光胆管造影在 LLLS 中安全可行，可减少供体和受体的胆道并发症。ICG的最佳剂量为0.004 mg/kg，注射后90分钟是最佳观察时间。建议在 LLLS 中常规使用 ICG 荧光胆管造影。

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来源期刊

Hepatobiliary surgery and nutrition Multiple-

自引率

10.00%

发文量

392

期刊介绍： Hepatobiliary Surgery and Nutrition (HBSN) is a bi-monthly, open-access, peer-reviewed journal (Print ISSN: 2304-3881; Online ISSN: 2304-389X) since December 2012. The journal focuses on hepatopancreatobiliary disease and nutrition, aiming to present new findings and deliver up-to-date, practical information on diagnosis, prevention, and clinical investigations. Areas of interest cover surgical techniques, clinical and basic research, transplantation, therapies, NASH, NAFLD, targeted drugs, gut microbiota, metabolism, cancer immunity, genomics, and nutrition and dietetics. HBSN serves as a valuable resource for professionals seeking insights into diverse aspects of hepatobiliary surgery and nutrition.