使用荧光素钠可视化胆道结构的腹腔镜荧光成像技术：猪模型临床前研究的结果

目的
近红外荧光成像最近已应用于肝胆外科领域。 作者的目标是在腹腔镜手术中应用蓝光荧光胆管造影术。 因此，作者设计了一项临床前研究，以评估在猪模型中使用蓝光荧光进行胆管造影术的可行性。

方法
在腹腔镜下，将 5 毫米的荧光素钠 (SF) 溶液注入 20 头雄性 3 种杂交（长白×约克夏×杜洛克）猪的胆囊。 在商业化发光二极管 (LED) 光源 (XLS1 extreme, Chammed) 发出的蓝光（峰值波长为 450 nm）下观察胆道树。

结果
在 20 个猪模型中的 18 个中，在将 SF 溶液注入胆囊后，可以立即在 LED 光源发出的蓝光下观察到胆道树。

结论
本研究为在腹腔镜手术中使用 SF 进行蓝光荧光胆道造影提供了临床前基础。 蓝光荧光成像技术用于腹腔镜胆囊切除术的临床可行性仍有待论证。

使用荧光素钠可视化胆道结构的腹腔镜荧光成像技术：猪模型临床前研究的结果

图 1
蓝光荧光的光源。 (A) 商业化的发光二极管 (LED) 光源。 (B) LED 光源发出的光的波长。

使用荧光素钠可视化胆道结构的腹腔镜荧光成像技术：猪模型临床前研究的结果

图 2
改良后的腹腔镜同时提供白光和蓝光。 (A) 连接到白光源和发光二极管光源的改良腹腔镜概述。 (B) 改良后的腹腔镜发出的白光穿透 12 毫米套管针。 (C) 改良后的腹腔镜发出的蓝光穿透 12 毫米套管针。

实验详细步骤
用阿法沙酮 (5 mg/kg)、甲苯噻嗪 (2 mg/kg) 和阿扎哌隆 (6 mg/kg) 的混合物麻醉猪，并执行以下程序。

i) 将 12 毫米套管针置于猪的脐部并用 CO2 气体充气。 建立气腹，腹内压维持在 12 mmHg 以下。
ii) 放置了两个额外的端口。
iii) 在白光下识别肝脏和胆囊，并将胆囊拉至腹膜。
iv) 将五毫米的 SF 溶液直接注入胆囊。 识别并截断了输注部位的小胆汁泄漏。
v) 在 LED 光源发出的蓝光下观察胆道结构。
vi) 猪在程序结束时被安乐死。

使用荧光素钠可视化胆道结构的腹腔镜荧光成像技术：猪模型临床前研究的结果

图 3
胆管的可视化。 (A) 当白光源被激活而发光二极管 (LED) 光源未被激活时。 (B) 当关闭白光源并打开 LED 光源时，肝外胆管在 LED 光源发出的蓝光下呈现荧光。 CD，胆囊管； CBD，胆总管。

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28.Published online 2023 Feb 28. doi: 10.4174/astr.2023.104.3.144