目的 探讨吲哚菁绿(ICG)荧光染色引导解剖性右半肝切除术在儿童肝脏肿瘤中应用价值。方法 回顾性分析本院收治的一例儿童肝母细胞瘤,采用经外周静脉注射ICG,通过“反染法”标记半肝断面,成功完成荧光引导下解剖性右半肝切除术的临床资料。探讨儿童ICG使用剂量、染色方式、肝脏及肝外胆道染色时间指标,染色断面对肝脏切除平面的指导意义。结果 应用ICG荧光染色引导下完成解剖性右半肝切除术,术中肝脏染色满意,肝外胆道染色显影清晰,术中出血150 mL,手术时间300 min。术后肝功能下降至正常,恢复顺利。结论 应用ICG荧光染色引导对儿童解剖性肝脏切除有重要价值,可能成为全新的儿童解剖性肝切除手术方式; 但对于ICG荧光染色成功率、安全性及对预后的影响还需大样本研究。
Objective To explore the value of indole cyanine green(ICG)fluorescent staining in guiding anatomic right-half hepatectomy in pediatric liver tumors. Methods For one hospitalized child of hepatoblastoma,ICG was injected into peripheral veins and semi-hepatic section was marked by “reverse staining method” for completing fluorescence guided anatomic right hemicectomy.To explore the dosage,staining method,liver and extrahepatic biliary tract staining time index of children with ICG,and the guiding significance of staining and breaking in the face of liver resection plane. Results ICG fluorescence staining was employed for guiding the successful completion of anatomic right-half hepatectomy.Liver was stained satisfactorily during operation and intraoperative bile duct staining showed distinct imaging.With an intraoperative bleeding volume of 150 mL,operative duration was 300 min.After operation,patient recovery was excellent and liver functions decreased to normal. Conclusion The application of ICG fluorescence staining can accurately guide children's anatomic liver resection.It is of great value for treating children's liver tumors.However,a comparative study on success rate,safety and prognosis of ICG fluorescence staining requires a large number of cases.
