吲哚菁绿荧光导航双镜联合经胆囊管探查胆总管的临床研究

Clinical study of indocyanine green fluorescence navigation laparoscopic and choledochoscopic transcystic common bile duct exploration

目的:比较吲哚菁绿荧光腹腔镜经胆囊管胆总管探查取石术与传统腹腔镜胆总管探查取石+T管引流术的临床疗效。方法:收集2021年10月至2022年11月为31例患者行吲哚菁绿荧光腹腔镜经胆囊管胆总管探查取石术(ICG组)与46例患者行传统腹腔镜胆总管探查取石+T管引流术(传统组)的临床资料,对比分析两组围术期临床资料及并发症情况。结果:手术均顺利完成,无中转开腹。两组手术时间、术后进食时间、腹腔引流时间差异均无统计学意义(P>0.05);ICG组术中出血量、住院时间及住院总花费均少于传统组,差异有统计学意义(P<0.05)。术后两组均未发生出血、感染及胆漏等并发症。结论:在严格把握手术适应证的前提下,吲哚菁绿荧光导航双镜联合经胆囊管胆总管探查术治疗胆总管结石效果满意,应用前景良好。

Objective:To compare the clinical efficacy of indocyanine green(ICG)fluorescence laparoscopic transcystic common bile duct exploration with traditional laparoscopic common bile duct exploration with T-tube drainage,and to discuss the therapeutic effect and application prospect of ICG fluorescence navigation laparoscopic transcystic common bile duct exploration.Methods:Clinical data of 31 cases of ICG fluorescence laparoscopic transcystic duct common bile duct exploration(ICG group)and 46 cases of traditional laparoscopic common bile duct exploration with T tube drainage(traditional group)were collected from Oct.2021 to Nov.2022.The perioperative clinical data and complications of the two groups were compared and analyzed retrospectively.Results:All patients s uccessfully completed the operation without conversion to laparotomy,and there were no statistically significant differences in operation time,postoperative feeding time and abdominal drainage time between the two groups(P>0.05).While the intraoperative blood loss,hospital stay and total hospitalization cost in ICG group were less than those in traditional group,and the difference was statistically s ignificant(P<0.05).No postoperative complications such as bleeding,infection or bile leakage occurred in the two groups.Conclusions:Under the premise of strict control of surgical indications,ICG fluorescence navigation transcystic common bile duct exploration is satisfactory and has a good application prospect in the treatment of choledocholithiasis.