荧光腹腔镜对胆囊切除术中胆囊三角识别的效果及临床应用价值分析

Effectiveness and clinical utility of fluoroscopic laparoscopy for gallbladder triangle identification during cholecystectomy

目的探讨在腹腔镜胆囊切除术(LC)中荧光腹腔镜引导对胆囊三角识别的效果及临床应用价值。方法随机选取400例、2020年1月~2022年12月期间收治的腹腔镜胆囊切除术(LC)患者,根据手术方案划分为观察组(荧光LC胆囊三角识别,200例)与对照组(常规LC,200例)。对比两组临床效果。结果两组患者的住院、手术及拔管时间、术中出血量无显著性差异(t=0.617,1.245,1.068,0.670;P>0.05)。两组患者术后丙氨酸、天门冬氨酸氨基转移酶(ALT、AST)水平均高于术前(t=0.122,0.099;P<0.05);两组术后ALT、AST水平无统计学意义(t=0.405,0.764;P>0.05)。观察组术后并发症发生率低于对照组(x^(2)=4.114,P<0.05)。结论在LC中荧光腹腔镜引导有助于术者准确识别胆囊三角,提升患者手术安全性,但荧光腹腔镜对LC手术效率、术中出血量、拔管及住院时间、ALT、AST均无明显影响。

Objective To investigate the efficacy and clinical application of fluorescence laparoscopic guidance for gallbladder triangle identification in laparoscopic cholecystectomy(LC).Methods A total of 400 patients who underwent laparoscopic cholecystectomy(LC)between January 2020 and December 2022 were randomly selected and divided according to the surgical protocol into an observation group(identification of gallbladder triangle with fluorescent LC,200 patients)and a control group(conventional LC,200 patients).Clinical effects were compared between the two groups.Results There was no significant difference in hospital stay,operation and extubation time,or intraoperative blood loss between the two groups(t=0.617,1.245,1.068,and 0.670,respectively;P>0.05).The levels of alanine and aspartate aminotransferase(ALT and AST)after operation were higher than those before operation in both groups(t=0.122,0.099;P<0.05);Postoperative ALT and AST levels were not statistically significant between the two groups(t=0.405,0.764;P>0.05).The incidence of postoperative complications in the observation group was lower than that in the control group(x^(2)=4.114,P<0.05).Conclusions Fluoroscopic laparoscopic guidance in LC helps the operator to accurately identify the gallbladder triangle and elevate patient surgical safety,but fluoroscopic laparoscopy has no significant effect on LC surgical efficiency,intraoperative blood loss,extubating and hospital stay,alt,AST.