The first experience of fluorescence laparoscopy for cholecystectomy, the bile ducts and the colon surgery
Journal Title: Хірургія України - Year 2018, Vol 0, Issue 4
Abstract
The aim — to analyse of the first experience with the use of fluorescence laparoscopy (FL) in technically difficult cholecystectomies, revision of the choledochus, lymphodection, colon resection and to assess the blood supply of the anastomosis sites. Materials and methods. Fluorescence laparoscopy was applied in 7 cholecystectomies for acute calculous cholecystitis, 6 common bile duct laparoscopic revisions to estimate the patency (first‑time used technique), laparoscopic right‑side hemicolectomy for estimation the blood supply of anastomosing intestinal areas and open resection of the transverse colon during limfodissections. Results and discussion. In cholecystectomies (fluorescence cholangiography), the duration of the operation and the average time to achieve a «critical type of safety» were reduced to 30 minutes compared with the comparison group (45 minutes). During the intraoperative revision of the choledochus in 1 case of fluorescence in the duodenum was not detected, which showed its obstruction (calculus inclusions). In other cases, the choledochal patency was preserved, which was associated with transient choledocholithiasis. With right‑sided hemicolectomy by fluorescent angiography, adequate blood supply to the colon stump has been proven. With open resection of the transverse colon, fluorescence lymphography was successfully used to visualize the apical lymph nodes at the mouth of the middle colon artery. Conclusions. The first experience showed that fluorescence laparoscopy allows to facilitate and accelerate dissection in case of technically difficult cholecystectomies, to assess the passage of the common bile duct in distinct cases (for example, transient choledocholithiasis), to evaluate the blood supply of the anastomotic sites in colon resections, and to monitor the adequacy of lymph node dissection.
Authors and Affiliations
A. V. Malinovskiy, M. M. Mayorenko, S. Y. Badion
Keywords
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- EP ID EP452021
- DOI 10.30978/SU2018-4-31
- Views 107
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