hepatoАнналы хирургической гепатологииAnnaly khirurgicheskoy gepatologii = Annals of HPB Surgery1995-54642408-9524НЭИКОН ИСП10.16931/1995-5464.20194131-138hepato-560Research ArticleЖЕЛЧНЫЕ ПУТИBILE DUCTSИнтраоперационная визуализация желчных протоков с помощью индоцианина зеленого при лапароскопической холецистэктомииFluorescent imaging with indocyanine green for intraoperative bilie ducts examination during laparoscopic cholecystectomyhttps://orcid.org/0000-0001-8539-4392ПанченковД. Н.PanchenkovD. N.

доктор медицинских наук, профессор, заведующий лабораторией минимально инвазивной хирургии, советник директора-главный научный сотрудник  

127473, г. Москва, ул.Делегатская, д.20, стр.1

115682, г. Москва, Ореховый бульвар д. 28

121165, Москва, ул. Студенческая, д. 40

Doct. of  Sci. (Med.), Professor, Head of the laboratory of minimally invasive surgery, Advisor of Director – chief researcher 

127473, Moscow, Delegatskaya str., 20, b. 1

115682, Moscow, Orekhovy bul. 28

121165, Moscow, Studyencheskaya str., 40

kirilltupikin87@gmail.comhttps://orcid.org/0000-0001-6209-4194ИвановЮ. В.IvanovYu. V.

доктор медицинских наук, профессор, заведующий отделением хирургии, главный научный сотрудник лаборатории минимально инвазивной хирургии 

127473, г. Москва, ул.Делегатская, д.20, стр.1

115682, г. Москва, Ореховый бульвар д. 28

Doct. of  Sci. (Med.), Professor, Chief of Department of surgery, Chief researcher of the laboratory of minimally invasive surgery 

127473, Moscow, Delegatskaya str., 20, b. 1

115682, Moscow, Orekhovy bul. 28

kirilltupikin87@gmail.comhttps://orcid.org/0000-0001-5467-0737ТупикинК. А.TupikinK. A.

кандидат медицинских наук, Старший научный сотрудник Лаборатории минимально инвазивной хирургии 

127473, Москва, ул. Делегатская, д. 20, стр. 1, Российская Федерация

Cand. of Sci. (Med.), Senior researcher of the laboratory of minimally invasive surgery

127473, Moscow, Delegatskaya str., 20, b. 1

kirilltupikin87@gmail.comhttps://orcid.org/0000-0002-8776-944XАстаховД. А.AstakhovD. A.

кандидат медицинских наук, ведущий научныйсотрудник Лаборатории минимально инвазивной хирургии, врач-онколог 

127473, г. Москва, ул.Делегатская, д.20, стр.1

115682, г. Москва, Ореховый бульвар д. 28

Cand. of Sci. (Med.), Leading researcher of the laboratory of minimally invasive surgery, oncologist 

127473, Moscow, Delegatskaya str., 20, b. 1

115682, Moscow, Orekhovy bul. 28

kirilltupikin87@gmail.comhttps://orcid.org/0000-0002-5455-2439ЛискевичР. В.LiskevichR. V.

младший научный сотрудник лаборатории минимально инвазивной хирургии, врач-хирург 

127473, г. Москва, ул.Делегатская, д.20, стр.1

115682, г. Москва, Ореховый бульвар д. 28

121165, Москва, ул. Студенческая, д. 40

Junior researcher of the laboratory of minimally invasive surgery, surgeon 

127473, Moscow, Delegatskaya str., 20, b. 1

115682, Moscow, Orekhovy bul. 28

121165, Moscow, Studyencheskaya str., 40

kirilltupikin87@gmail.comФГБОУ ВО МГМСУ им. А.И. Евдокимова Минздрава России, ФГБУ ФНКЦ ФМБА России, ФГБУ ГНЦ лазерной медицины им. О.К. Скобелкина ФМБА РоссииРоссияA.I. Еvdokimov Moscow State University of Medicine and Dentistry, Federal scientific and clinical center of specialized types of medical care and medical technologies of FMBA of Russia, Skobelkin State Scientific Center of Laser Medicine FMBARussian FederationФГБОУ ВО МГМСУ им. А.И. Евдокимова Минздрава России, ФГБУ ФНКЦ ФМБА РоссииРоссияA.I. Еvdokimov Moscow State University of Medicine and Dentistry, Federal scientific and clinical center of specialized types of medical care and medical technologies of FMBA of RussiaRussian FederationМосковский государственный медико-стоматологический университет имени А.И. ЕвдокимоваРоссияA.I. Еvdokimov Moscow State University of Medicine and DentistryRussian FederationФГБОУ ВО МГМСУ им. А.И. Евдокимова Минздрава России, ФГБУ ФНКЦ ФМБА РоссииРоссияA.I. Еvdokimov Moscow State University of Medicine and Dentistry, Federal scientific and clinical center of specialized types of medical care and medical technologies of FMBA of RussiaRussian Federation201903122019244131138Copyright © Панченков Д.Н., Иванов Ю.В., Тупикин К.А., Астахов Д.А., Лискевич Р.В., 20192019Панченков Д.Н., Иванов Ю.В., Тупикин К.А., Астахов Д.А., Лискевич Р.В.Panchenkov D.N., Ivanov Y.V., Tupikin K.A., Astakhov D.A., Liskevich R.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://hepato.elpub.ru/jour/article/view/560

Цель. Оценка возможности ранней идентификации желчных протоков с применением света в ближнем инфракрасном диапазоне и флюоресцентного агента индоцианина зеленого при лапароскопической холецистэктомии у пациентов с повышенным риском повреждения желчных протоков.Материал и методы. Лапароскопическая холецистэктомия выполнена 16 пациентам с различными факторами риска травмы желчных протоков. Для интраоперационного определения топографии желчных протоков применяли систему флюоресцентной диагностики.Результаты. Применение интраоперационной диагностики в ряде наблюдений облегчило идентификацию трубчатых структур в проекции треугольника Кало и позволило избежать конверсии.Заключение. Первый опыт интраоперационного обнаружения желчных протоков с помощью индоцианина зеленого при лапароскопической холецистэктомии свидетельствует о том, что метод может стать важной дополнительной процедурой у пациентов с повышенным риском повреждения желчных протоков. Необходимы дальнейшие исследования для оптимизации методов, определения дозы, времени и критериев отбора пациентов.

Aim. Assessment of the capability of early identification of the bile ducts using near infrared light and fluorescent agent indocyanine green in laparoscopic cholecystectomy in patients with an increased risk of bile duct injury.Methods. Laparoscopic cholecystectomy using fluorescent imaging system was performed in 16 patients with different risk factors for bile duct injury.Results. The use of intraoperative imaging in a number of cases facilitated the identification of tubular structures in the Calot triangle and allowed to avoid the conversion. Conclusion. The first experience of intraoperative imaging of bile ducts using indocyanine green in laparoscopic cholecystectomy indicate that this method can become an important additional diagnostic procedure in patients with an increased risk of bile duct injury. Further research is needed to optimize methods, dosage, time and patient selection criteria.

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The authors declare that there are no conflicts of interest present.