吲哚菁绿荧光显像指导腹腔镜胆囊切除术治疗胆囊良性疾病患者效果研究

Laparoscopic cholecystectomy under guidance of indocyanine green fluorescence imaging in treatment of patients with benign gallbladder diseases

目的 探讨吲哚菁绿(ICG)荧光显像技术在腹腔镜胆囊切除术(LC)中的应用价值。方法 2021年10月~2022年7月我科收治的62例胆囊良性疾病患者,被分为两组,分别行ICG荧光导航LC或普通LC术。结果 两组均顺利完成手术,术中均未发生医源性胆道损伤,对照组发生中转开腹1例(3.2%);荧光LC组辨识胆总管和胆囊管时间、分离出胆囊管和胆囊动脉时间、胆囊切除总用时和术中出血量分别为0.5(0.5,1)min、(16.9±0.4)min、30(28,33)min和15(5,20)ml,显著短于或少于对照组【分别为2(1,3)min、(24.9±0.1)min、46(39,53)min和30(20,40)ml,P<0.05】;两组术后并发症发生率比较,无显著性差异(0.0%对3.2%,P>0.05)。结论 采用ICG荧光导航LC手术是一种非常有用的辅助工具,其实时显像辨别胆道解剖结构,提高了手术效率,减少了医源性胆道损伤,缩短了手术时间。

Objective The purpose of this study was to investigate the application of indocyanine green(ICG)fluorescence imaging in laparoscopic cholecystectomy(LC)in the treatment of patients with benign gallbladder diseases.Methods 62 patients with benign gallbladder diseases,such as cholecystolithiasis and chronic cholecystitis,etc,were encountered in our hospital between October 2021 and July 2022,and were divided into two groups,with 31 cases in each,underwent LC under ICG fluorescent navigation or routine operation.Results The operation was successfully completed,and no iatrogenic biliary duct injury occurred in the two groups;one patient(3.2%)in the control group was transferred to open laparotomy;the time of identification and complete anatomic isolation of three tubes,operation time and intraoperative blood loss in the fluorescent navigation group were 0.5(0.5,1)min,(16.9±0.4)min,30(28,33)min and 15(5,20)ml,all significantly shorter or less than[2(1,3)min,(24.9±0.1)min,46(39,53)min and 30(20,40)ml,respectively,P<0.05]in routine operation group;there was no significant difference respect to post-operational complications in the two groups(0.0%vs.3.2%,P>0.05).Conclusion The ICG fluorescence navigation during LC is a very good measure,especially in difficult surgeries,which might be helpful to identify the anatomical structure of biliary duct,shorten operation times and reduce iatrogenic bile duct injury.