RESUMEN
Multimodality therapy based on surgery is the main treatment method for hepatocellular carcinoma (HCC), and hepatectomy requires the removal of primary tumor and the preservation of normal liver tissue to the maximum extent. However in clinical surgery, it is difficult to accurately identify tumor tissue and its boundary with visual inspection and palpation, which often results in under-resection or over-resection. Near-infrared fluorescence (NIRF) imaging is a real-time noninvasive imaging technique with low costs and high sensitivity, and extensive studies have been conducted to investigate its application in guiding surgical resection of tumors. With the development of fluorescence imaging system and fluorescence probe, intraoperative tumor localization and boundary determination can be realized to make the surgery more accurate. This article reviews the development of various NIRF probes for intraoperative navigation in HCC and discusses current challenges and potential opportunities of these imaging probes.
RESUMEN
Objective To explore the selection of palliate operation styles for unresectable malignant obstructive jaundice diseases. Methods The clinical data of 112 cases of unresectable malignant obstructive jaundice diseases in the last 5 years were analyzed retrospectively. Results The rate of operation mortality was 7.1％ and the incidence rate of post-operative cholangitis was 17.3 ％.The survival time in the Roux-en-Y choledochojejunostomy group was (9.4±1.6) months, and there were no significant differences among laparotomy stent internal drainage group[(9.8±12.5)months]and the PTCD stent internal drainage group [(9.0± 3.1)months]. But survival time in the laparotomy bridge internal drainage group [(6.8±1.7)months]was significantly lower (P＜0.05). The survival times in the ERCP stent drainage group [(3.5±2.2)months]and exploratory laparotomy group [(2.8±2.7)months]were even more significantly lower (P＜0.01).Conclusion As a palliative operation for unresectable malignant obstructive jaundice diseases, Roux-en-Y choledochojejunostomy applies to the middle and distal obstruction,laparotomy stent internal drainage applies to hilar obstruction,ERCP stent drainage only applies to distal obstruction,and PTCD stent internal drainage applies to any part obstruction of the bile duct. The Roux-en-Y choledochojejunostomy, laparotomy stent internal drainage, and PTCD stent internal drainage would improve the life time and life quality of these patients.