吲哚菁绿荧光影像引导在复杂肝胆道结石手术中胆道识别的临床应用研究  

Clinical Application of Indocyanine Green Fluorescence Imaging Guidance in Biliary Tract Recognition in Complex Hepatolithiasis Surgery

作　　者：王锦祥[1] 郑俊城 洪旭雯 刘特彬[1] 李晓辉[1] WANG Jinxiang;ZHENG Juncheng;HONG Xuwen;LIU Tebin;LI Xiaohui(Puning People’s Hospital,Puning 515300,China)

机构地区：[1]广东省普宁市人民医院,广东普宁515300

出　　处：《中国医学创新》2021年第35期123-126,共4页Medical Innovation of China

基　　金：2021年度揭阳市卫生医疗科技创新项目(ylxm022)。

摘　　要：目的:探讨吲哚菁绿(ICG)荧光影像引导在复杂肝胆道结石手术中胆道识别的临床应用。方法:选取2021年1-9月本科收治的行再次胆道探查取石的复杂肝胆道结石手术患者120例作为研究对象,按随机数字表法分为对照组和观察组,每组60例。对照组采取常规腹腔镜肝外胆管探查术,观察组在对照组的基础上术中采取ICG荧光融合影像引导。记录并比较两组术中术后情况。结果:观察组手术时间、寻找胆总管时间均短于对照组,术中出血量少于对照组,差异均有统计学意义(P<0.05);观察组胆总管损伤率为0,低于对照组的10.00%(P<0.05);观察组其他并发症发生率为3.33%,明显低于对照组的15.00%(P<0.05)。观察组排气时间、住院时间均短于对照组(P<0.05)。结论:吲哚菁绿荧光影像引导可实时显示肝胆道系统,有效缩短手术时间,避免胆道损伤,减少并发症的发生。Objective:To explore the clinical application of indocyanine green (ICG) fluorescence imaging guidance in biliary tract recognition in complex hepatolithiasis surgery.Method:A total of 120 patients with complex hepatobiliary tract stone surgery admitted to our department from January to September 2021 who underwent biliary tract exploration and stone removal were selected as the research objects,according to the random number table,they were divided into the control group and the observation group,60 cases in each group.The control group was given conventional laparoscopic extrahepatic bile duct exploration,and the observation group was guided by ICG fluorescence fusion imaging during the operation on the basis of the control group.The intraoperative and postoperative conditions of two groups were recorded and compared.Result:The operation time,common bile duct search time of the observation group were shorter than those of the control group,the intraoperative blood loss was less than that of the control group,the differences were statistically significant (P<0.05).The bile duct damage rate of the observation group was 0,which was lower than 10.00% of the control group (P<0.05);the total incidence of other complications of the observation group was 3.33%,which was significantly lower than 15.00% of the control group (P<0.05).The exhaust time and hospitalization time of the observation group were shorter than those of the control group (P<0.05).Conclusion:ICG fluorescence imaging guidance can display the hepatobiliary system in real time,effectively shorten the operation time,avoid bile duct damage,and reduce the occurrence of complications.

关 键 词：吲哚菁绿荧光影像 肝胆道结石 胆道探查 胆道识别 

分 类 号：R657.4[医药卫生—外科学]