Near-Infrared Fluorescence Imaging in Patients Undergoing Pancreaticoduodenectomy
Near-Infrared Fluorescence Imaging in Patients Undergoing Pancreaticoduodenectomy
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DOI：
10.1159/000329411
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发表时间：
2011-01-01
影响因子：
1.6
通讯作者：
Vahrmeijer, A. L.
中科院分区：
文献类型：
--
作者：
Hutteman, M.;van der Vorst, J. R.;Vahrmeijer, A. L.
背景：胰腺肿瘤术中可视化有可能提高根治性切除率。术中胆总管和胆管狭窄的可视化可能具有附加价值。在这项研究中，我们探讨了使用吲哚菁绿色（ICG）的这些应用，并试图优化注射时间和剂量。方法：8例胰十二指肠切除术患者，静脉注射ICG 5或10 mg。在注射期间和注射后，使用Mini-FLARE TM近红外（NIR）成像系统对胰腺、肿瘤、胆总管和周围器官进行真实的实时成像。结果：除1例偶见造影剂外，未见明显的肿瘤-胰腺造影剂。在注射后10分钟内，使用NIR荧光清晰地可视化胆总管，在注射后30分钟和90分钟之间具有最大对比度。由于ICG的胆汁排泄，可以观察到胆汁性胆管炎的通畅性。结论：胰腺癌患者静脉注射ICG后，不能观察到有用的肿瘤分界。然而，在观察期内，胆总管和胆道狭窄清晰可见。因此，在外科解剖结构异常或难以识别的情况下，这些成像策略在胆道手术期间可能是有益的。版权所有（C）2011 S. Karger AG，巴塞尔
Background: Intraoperative visualization of pancreatic tumors has the potential to improve radical resection rates. Intraoperative visualization of the common bile duct and bile duct anastomoses could be of added value. In this study, we explored the use of indocyanine green (ICG) for these applications and attempted to optimize injection timing and dose. Methods: Eight patients undergoing a pancreaticoduodenectomy were injected intravenously with 5 or 10 mg ICG. During and after injection, the pancreas, tumor, common bile duct and surrounding organs were imaged in real time using the Mini-FLARE TM near-infrared (NIR) imaging system. Results: No clear tumor-to-pancreas contrast was observed, except for incidental contrast in 1 patient. The common bile duct was clearly visualized using NIR fluorescence, within 10 min after injection, with a maximal contrast between 30 and 90 min after injection. Patency of biliary anastomoses could be visualized due to biliary excretion of ICG. Conclusion: No useful tumor demarcation could be visualized in pancreatic cancer patients after intravenous injection of ICG. However, the common bile duct and biliary anastomoses were clearly visualized during the observation period. Therefore, these imaging strategies could be beneficial during biliary surgery in cases where the surgical anatomy is aberrant or difficult to identify. Copyright (C) 2011 S. Karger AG, Basel