三维CT重建联合吲哚菁绿显影技术应用于腹腔镜保留十二指肠的胰头切除术2例报道_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

张帅 ¹ , 费发珠 ¹ , 韩欣 ² , 王伟 ¹ , 邵艺超 ¹ , 杨新涛 ¹ , 王海久 ¹ ,  侯立朝 ¹

1. ;
2. ;

Corresponding author：

侯立朝, Email: zhuoyue_1973@163.com

Keywords：

胰腺肿瘤; 腹腔镜; 三维重建; 吲哚菁绿; 保留十二指肠胰头切除术

DOI：

10.7507/1007-9424.202311023

Video：

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目的探讨三维CT重建联合吲哚菁绿显影技术应用于腹腔镜保留十二指肠胰头切除术（laparoscopic duodenum-preserving pancreatic head resection，LDPPHR）相关经验。方法回顾性分析青海大学附属医院2022年5月至2022年8月期间在三维CT重建联合吲哚菁绿荧光导航下行LDPPHR 2例患者的临床资料。结果 2例患者均顺利完成LDPPHR，年龄分别为53和55岁，2例患者均为女性，手术时间分别为445和425 min，术中出血量分别为200和250 mL，2例患者均使用了负压冲洗引流管，1例患者术后发生胰腺生化漏，经治疗后均恢复正常，2例均未发生严重并发症。2例患者术后住院时间分别为12和25 d，术后病理学检查结果提示胰腺浆液性囊腺瘤1例，胰腺真性上皮性囊肿1例。术后随访时间分别为13和10个月，随访期间内均未出现胰腺内、外分泌功能障碍。结论三维CT重建联合吲哚菁绿应用于LDPPHR是一种安全、有效的手术方式，能有效辨别术中胆管解剖结构，并能发现术中微小胆管损伤，避免术后胆汁漏的发生。

1.	Beger HG, Krautzberger W, Bittner R, et al. Duodenum-sparing pancreas head resection in chronic pancreatitis—results after 10 years' use. Langenbecks Arch Chir, 1984, 362(4): 229-236.
2.	Beger HG, Witte C, Krautzberger W, et al. Experiences with duodenum-sparing pancreas head resection in chronic pancreatitis. Chirurg, 1980, 51(5): 303-307.
3.	Beger HG, Siech M, Poch B. Duodenumerhaltende totale pankreaskopfresektion. Der Chirurg, 2013, 84(5): 412-420.
4.	李兆申, 金震东, 李汛. 中国胰腺囊性肿瘤诊断指南(2022年). 临床肝胆病杂志, 2023, 39(2): 290-298.
5.	张太平, 罗文浩, 邱江东, 等. 对胰腺囊性肿瘤手术指征的再思考. 中华外科杂志, 2022, 60(7): 646-650.
6.	Diener MK, Hüttner FJ, Kieser M, et al. Partial pancreatoduodenectomy versus duodenum-preserving pancreatic head resection in chronic pancreatitis: the multicentre, randomised, controlled, double-blind ChroPac trial. Lancet, 2017, 390(10099): 1027-1037.
7.	Takada T, Yasuda H, Amano H, et al. A duodenum-preserving and bile duct–preserving total pancreatic head resection with associated pancreatic duct-to-duct anastomosis. J Gastrointest Surg, 2004, 8(2): 220-224.
8.	Cai Y, Zheng Z, Gao P, et al. Laparoscopic duodenum-preserving total pancreatic head resection using real-time indocyanine green fluorescence imaging. Surg Endosc, 2021, 35(3): 1355-1361.
9.	范应方, 方驰华. 三维可视化技术在肝胆外科临床应用的争议与共识. 中国实用外科杂志, 2018, 38(2): 137-141.
10.	Inoue Y, Saiura A, Arita J, et al. Hepatic vein-oriented liver resection using fusion indocyanine green fluorescence imaging. Ann Surg, 2015, 262(6): e98-e99.
11.	Lu C, Xu B, Mou Y, et al. Laparoscopic duodenum-preserving pancreatic head resection with real-time indocyanine green guidance of different dosage and timing: enhanced safety with visualized biliary duct and its long-term metabolic morbidity. Langenbecks Arch Surg, 2022, 407(7): 2823-2832.
12.	Beger HG, Mayer B, Rau BM. Parenchyma-sparing, limited pancreatic head resection for benign tumors and low-risk periampullary cancer—a systematic review. J Gastrointest Surg, 2016, 20(1): 206-217.
13.	王强. 不同负压引流模式对胰十二指肠切除术后并发症的影响. 复旦大学, 2014.
14.	董家鸿, 杨世忠. 精准肝切除的技术特征与临床应用. 中国实用外科杂志, 2010, 30(8): 638-640.
15.	Cao J, Li G, Wei J, et al. Laparoscopic duodenum-preserving total pancreatic head resection: a novel surgical approach for benign or low-grade malignant tumors. Surg Endosc, 2019, 33(2): 633-638.
16.	韩蔷, 吴昊钧, 陈利平. 三维重建及吲哚菁绿辅助下开展腹腔镜保留十二指肠胰头切除术1例报道. 中国普外基础与临床杂志, 2022, 29(9): 1160-1164.

1. Beger HG, Krautzberger W, Bittner R, et al. Duodenum-sparing pancreas head resection in chronic pancreatitis—results after 10 years' use. Langenbecks Arch Chir, 1984, 362(4): 229-236.
2. Beger HG, Witte C, Krautzberger W, et al. Experiences with duodenum-sparing pancreas head resection in chronic pancreatitis. Chirurg, 1980, 51(5): 303-307.
3. Beger HG, Siech M, Poch B. Duodenumerhaltende totale pankreaskopfresektion. Der Chirurg, 2013, 84(5): 412-420.
4. 李兆申, 金震东, 李汛. 中国胰腺囊性肿瘤诊断指南(2022年). 临床肝胆病杂志, 2023, 39(2): 290-298.
5. 张太平, 罗文浩, 邱江东, 等. 对胰腺囊性肿瘤手术指征的再思考. 中华外科杂志, 2022, 60(7): 646-650.
6. Diener MK, Hüttner FJ, Kieser M, et al. Partial pancreatoduodenectomy versus duodenum-preserving pancreatic head resection in chronic pancreatitis: the multicentre, randomised, controlled, double-blind ChroPac trial. Lancet, 2017, 390(10099): 1027-1037.
7. Takada T, Yasuda H, Amano H, et al. A duodenum-preserving and bile duct–preserving total pancreatic head resection with associated pancreatic duct-to-duct anastomosis. J Gastrointest Surg, 2004, 8(2): 220-224.
8. Cai Y, Zheng Z, Gao P, et al. Laparoscopic duodenum-preserving total pancreatic head resection using real-time indocyanine green fluorescence imaging. Surg Endosc, 2021, 35(3): 1355-1361.
9. 范应方, 方驰华. 三维可视化技术在肝胆外科临床应用的争议与共识. 中国实用外科杂志, 2018, 38(2): 137-141.
10. Inoue Y, Saiura A, Arita J, et al. Hepatic vein-oriented liver resection using fusion indocyanine green fluorescence imaging. Ann Surg, 2015, 262(6): e98-e99.
11. Lu C, Xu B, Mou Y, et al. Laparoscopic duodenum-preserving pancreatic head resection with real-time indocyanine green guidance of different dosage and timing: enhanced safety with visualized biliary duct and its long-term metabolic morbidity. Langenbecks Arch Surg, 2022, 407(7): 2823-2832.
12. Beger HG, Mayer B, Rau BM. Parenchyma-sparing, limited pancreatic head resection for benign tumors and low-risk periampullary cancer—a systematic review. J Gastrointest Surg, 2016, 20(1): 206-217.
13. 王强. 不同负压引流模式对胰十二指肠切除术后并发症的影响. 复旦大学, 2014.
14. 董家鸿, 杨世忠. 精准肝切除的技术特征与临床应用. 中国实用外科杂志, 2010, 30(8): 638-640.
15. Cao J, Li G, Wei J, et al. Laparoscopic duodenum-preserving total pancreatic head resection: a novel surgical approach for benign or low-grade malignant tumors. Surg Endosc, 2019, 33(2): 633-638.
16. 韩蔷, 吴昊钧, 陈利平. 三维重建及吲哚菁绿辅助下开展腹腔镜保留十二指肠胰头切除术1例报道. 中国普外基础与临床杂志, 2022, 29(9): 1160-1164.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

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