吲哚菁绿荧光显影在困难胆囊腹腔镜胆囊切除术中的应用价值  

Application value of indocyanine green fluorescence imaging in laparoscopic cholecystectomy of difficult gallbladder

作　　者：冯其柱[1,2] 王思雨 张超 FENG Qizhu;WANG Siyu;ZHANG Chao(Department of General Surgery,First Affiliated Hospital of Anhui Medical University,Hefei 230001,China;Department of General Surgery,First Affiliated Hospital of Anhui University of Science and Technology,Huainan,Anhui 232007,China)

机构地区：[1]安徽医科大学第一附属医院普外科,合肥230001 [2]安徽理工大学第一附属医院普外科,安徽淮南232007

出　　处：《临床肝胆病杂志》2022年第11期2537-2541,共5页Journal of Clinical Hepatology

基　　金：安徽高校自然科学研究基金资助重点项目(KJ2021A0439)。

摘　　要：目的探讨吲哚菁绿(ICG)荧光显影在困难胆囊腹腔镜胆囊切除术(LC)中的应用价值。方法回顾性分析安徽医科大学第一附属医院2021年10月—12月行LC的患者临床资料,根据术中是否使用ICG荧光显影和是否为困难胆囊分为4组:A组为使用ICG荧光显影普通胆囊,B组为使用ICG荧光显影困难胆囊,C组为未使用ICG荧光显影普通胆囊,D组为未使用ICG荧光显影困难胆囊。比较各组手术时间、术中出血、住院时间、住院费用和术后并发症间的差异。正态分布的计量资料2组间比较采用t检验。计数资料2组间比较用χ2检验或Fisher确切概率法。结果A组与C组相比手术时间、术中出血、住院时间、住院费用和术中并发症,差异均无统计学意义(P值均>0.05)。B组手术时间和术中出血分别为(75.41±12.96)min和(18.27±6.97)mL,D组分别为(106.78±19.21)min和(23.99±8.43)mL,两组相比差异均有统计学意义(P值均<0.05);B组住院时间、住院费用和术后并发症与D组相比,差异均无统计学意义(P值均>0.05)。结论普通胆囊患者LC术中使用ICG荧光显影优势不明显;但在困难胆囊中,ICG荧光显影有利于胆道显露,可以缩短手术时间,减少术中出血。Objective To investigate the clinical utility of indocyanine green(ICG)fluorescence imaging in difficult laparoscopic cholecystectomy(LC).Methods The clinical data of LC patients from October 2021 to December 2021 in the First Affiliated Hospital of Anhui Medical University were retrospectively analyzed.Based on whether ICG fluorescence imaging was used and whether gallbladder difficulties were detected,the patients were divided into four groups:ICG common gallbladder(Group A),ICG difficult gallbladder(Group B),common gallbladder(Group C),and difficult gallbladder(Group D).The operative time,intraoperative bleeding,length of hospital stay,hospitalization cost and postoperative complications were compared.Comparison of normally distributed continuous data between groups was performed by t test.Comparison of categorical data between groups was performed using the chi-square test or Fisher’s exact probability method.Results The operative time,intraoperative bleeding,length of hospital stay,hospitalization cost and intraoperative complications in group A were comparable to those in Group C(all P>0.05).The operative time and intraoperative bleeding were(75.41±12.96)min and(18.27±6.97)mL in group B,vs(106.78±19.21)min and(23.99±8.43)mL in group D,respectively,and the differences were statistically significant(all P<0.05),while the length of hospitalization,hospitalization cost and postoperative complications in group B were comparable to those in group D(all P>0.05).Conclusion The benefits of ICG fluorescence imaging during LC in patients with the common gallbladder are not obvious.However,in difficult gallbladder cases,ICG fluorescence imaging can improve biliary tract exposure and reduce operation time and intraoperative bleeding.

关 键 词：胆囊切除术 腹腔镜 吲哚花青绿 治疗结果 

分 类 号：R657.4[医药卫生—外科学]