Surgical Administration of Indocyanine Green in Hepatectomy for Improved Bile Leakage Detection
Surgical Administration of Indocyanine Green in Hepatectomy for Improved Bile Leakage Detection
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DOI：
10.21873/anticanres.15983
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发表时间：
2022-10-01
影响因子：
2
通讯作者：
Fujiwara, Yoshiyuki
中科院分区：
文献类型：
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作者：
Hanaki, Takehiko;Goto, Keisuke;Fujiwara, Yoshiyuki
背景/目的：肝切除术后的胆瘘（BF）是一个值得关注的并发症，完全预防肝切除术后BF的方法尚未开发。我们的目的是研究使用全身给药吲哚菁绿色（ICG），以防止胆漏（BL）从切割表面的肝脏。患者和方法：研究样本包括26例接受肝切除术而未使用ICG的患者（常规观察组; CO-G）和23例接受术中使用全身给药ICG检测BL的肝切除术患者（ICG观察组; IO-G）。我们比较了使用肉眼常规评估观察到来自切除肝脏的BL的患者和使用ICG渗漏作为BL指标的患者之间的引流流出物中的胆红素水平。在IO-G中，我们还将肉眼可见的切除平面上的BL斑点的数量与ICG相机上的可见斑点的数量进行了比较。结果如下：术后3天，IO-G引流液中的胆红素水平显著低于CO-G（1.3 vs. 1.9 mg/dl，p=0.019）。2例（7.7%）国际肝脏外科研究组（ISGLS）B级胆瘘发生在CO-G，而IO-G没有发生。在IO-G中，使用ICG相机观察肝切除术后检测到的BL斑点数量显著高于肉眼观察（0.22 vs. 0.91斑点，p
Background/Aim: Biliary fistulas (BFs) following hepatic resection are a complication of concern, and methods to completely prevent BFs after hepatic resection have yet to be developed. Our aim was to study the use of systemically administered indocyanine green (ICG) for preventing bile leakage (BL) from the cut surface of the liver. Patients and Methods: The study sample comprised 26 patients who underwent hepatectomy without ICG (conventional observation group; CO-G) and 23 hepatectomy patients who underwent intraoperative detection of BL using systemically administered ICG (ICG observation group; IO-G). We compared the bilirubin levels in drainage effluent between patients in whom BL from the resected liver was observed using conventional assessment with the naked eye and those in whom ICG leakage was used as an indicator of BL. In the IO-G, we also compared the number of BL spots on the resected plane visible to the naked eye with the number of visible spots on an ICG camera. Results: Three days after surgery, the bilirubin levels in the drainage fluid of the IO-G were significantly lower than those in the CO-G (1.3 vs. 1.9 mg/dl, p=0.019). Two cases (7.7%) of International Study Group of Liver Surgery (ISGLS) grade B biliary fistula occurred in the CO-G, but none in the IO-G. In the IO-G, the number of BL spots detected just after hepatectomy was significantly higher using ICG camera observation than the naked eye observation (0.22 vs. 0.91 spots, p