中国普通外科杂志2025，Vol.34Issue(1)：88-95,8.DOI:10.7659/j.issn.1005-6947.240673
ICG荧光导航联合Laennec膜入路在腹腔镜左半肝切除术的应用
Application of ICG fluorescence navigation combined with the Laennec's capsule approach in laparoscopic left hepatectomy
摘要
Abstract
Background and Aims:Precise localization of lesions and optimization of the surgical approach are crucial in laparoscopic left hepatectomy.Traditional surgical techniques have certain limitations,whereas indocyanine green(ICG)fluorescence navigation can accurately delineate the boundaries of liver lesions.The Laennec's capsule approach aids in clearly exposing intrahepatic structures.This study was conducted to evaluate the clinical effectiveness of combining ICG fluorescence navigation with the Laennec's capsule approach in laparoscopic left hepatectomy. Methods:The clinical data of 44 liver cancer patients who underwent surgery at the Hepatobiliary Surgery Department of Xuanhan People's Hospital from January 2023 to November 2024 were retrospectively collected.Among them,22 patients underwent laparoscopic left hepatectomy with Pringle's maneuver for total hepatic inflow occlusion(control group),while the other 22 patients received laparoscopic left hepatectomy using ICG fluorescence navigation combined with the Laennec's capsule approach(observation group).The two groups were compared in terms of intraoperative surgical time,average blood loss,intraoperative transfusion rate,liver function on postoperative days(POD)1,3,and 7[total bilirubin(TBIL),aspartate aminotransferase(AST),alanine aminotransferase(ALT)],average length of hospital stay,gastrointestinal function recovery time,POD 1-6 drainage volume,incidence of postoperative complications,and short-term efficacy. Results:The observation group had significantly shorter average surgical time than the control group[(218.19±39.18)min vs.(245.23±44.36)min,P＜0.05]and less average blood loss[(320.44±78.62)mL vs.(456.37±88.16)mL,P＜0.05].The intraoperative transfusion rate between the two groups was not significantly different(13.64％vs.9.09％,P＞0.05).The observation group had significantly less postoperative drainage POD 1-6 than the control group[(431.19±152.18)mL vs.(528.23±184.36)mL,P＜0.05].The average hospital stay and gastrointestinal function recovery time were shorter in the observation group[(9.21±2.92)d vs.(12.72±3.24)d;(2.24±0.42)d vs.(3.35±0.53)d,both P＜0.05].Postoperative liver function tests(TBIL,AST,ALT)on days 1,3,and 7 were significantly lower in the observation group compared to the control group(all P＜0.05).The difference in the overall response rate between the two groups was not statistically significant(72.73％vs.77.27％,P＞0.05).No severe postoperative complications occurred in either group. Conclusion:The combination of ICG fluorescence navigation with the Laennec's capsule approach demonstrates favorable clinical outcomes in laparoscopic left hepatectomy and is worthy of clinical promotion.关键词
肝肿瘤/肝切除术/腹腔镜/吲哚花青绿Key words
Liver Neoplasms/Hepatectomy/Laparoscopes/Indocyanine Green分类
医药卫生引用本文复制引用
陈姜,王春荣,曹家洪,喻晨..ICG荧光导航联合Laennec膜入路在腹腔镜左半肝切除术的应用[J].中国普通外科杂志,2025,34(1):88-95,8.基金项目
四川省医学科研课题计划资助项目(Q23066). （Q23066）
