术前应用靛氰绿检测联合三维重建成像评估肝门部胆管癌肝脏储备功能

目的探讨肝门部胆管癌患者肝切除术前肝脏储备功能的评估方法及意义。方法单治疗组手术的肝门部胆管癌患者72例。比较通过靛氰绿(ICG)检测、三维成像(3D)重建评估后手术患者并发症发生率。结果 72例患者中,67例患者行ICG检测,56例ICG 15分钟滞留率(R15)10%,11例ICG R1510%。3D重建评估预留肝体积为(860.32±235.41)cm3,预留脏脏体积/全肝体积为38%~75%。32例患者术前采用ICG联合3D重建。术后并发胆漏5例,腹腔积液11例,并发症发生率为22.2%。各组间术后并发症发生率悲剧差异有统计学意义(P0.05)。结论术前ICG检查联合3D重建评估可定量评价患者肝脏储备功能,做出准确手术规划,减少术后并发症。

Preoperative evaluation of hepatic functional reserve with indocyanine green retention test and three-dimensional imaging in hilar cholangiocarcinoma

Objective To explore the methods and significance of preoperative evaluation of he-patic functional reserve in hilar cholangiocarcinoma(HC)before hepatectomy. Methods A total of 72 HC cases were selected. Indocyanine green(ICG)retention test and three-dimensional(3D)reconstruction were applied to evaluate the incidence of postoperative complication. Results Among the 72 HC patients,67 patients received indocyanine green retention test after 15 min(ICG-R15),including 56 cases with a ICG-R15 value less than 10% and 11 cases with a ICG-R15 value great than 10% . The reserved liver volume was(860. 32 ± 235. 41)cm3 . The reserved liver volume/ total liver volume ranged from 38% to 75% . Thir-ty-two patients received both ICG retention test combined with 3D reconstruction. Postoperative complica-tions included 5 cases of bile leakage and 11 cases of ascites,with a complication incidence of 22. 2% . There was a significant difference in the incidence of postoperative complications between the groups(P <0. 05). Conclusion The ICG retention test plus three-dimensional imaging can evaluate hepatic function-al reserve quantitatively. It may help surgeons to make an accurate operative planning and reduce postop-erative complications for HC patients.