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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 R15>10%。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(P<0.05)。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。
Objective To investigate the method and significance of liver reserve function in patients with hilar cholangiocarcinoma before hepatectomy. Methods A total of 72 patients with hilar cholangiocarcinoma undergoing operation in a single treatment group. Comparisons of surgical patient complication rates after three-dimensional imaging (3D) reconstruction with indocyanine green (ICG) testing were performed. Results Of the 72 patients, ICG was detected in 67 patients, ICG 15% retention rate (R15) in 56 patients, and 10% ICG R15 in 11 patients. The volume of liver reserved for 3D reconstruction assessment was (860.32 ± 235.41) cm3, and the reserve dirty / total liver volume was 38% -75%. Thirty-two patients underwent ICG combined with 3D reconstruction before surgery. Postoperative biliary leakage in 5 cases, 11 cases of abdominal effusion, the complication rate was 22.2%. The incidence of postoperative complications among the groups was significantly different (P <0.05). Conclusion Preoperative ICG examination combined with 3D reconstruction assessment can quantitatively evaluate the patient’s liver reserve function, make accurate surgical planning and reduce postoperative complications.