吲哚菁绿分子荧光显像在腹腔镜下复杂胆囊切除术中的临床应用  

Clinical Application of Indocyanine Green Molecular Fluorescence Image in Laparoscopic Complicated Cholecystectomy

作　　者：吴鹏 秦蜀 许维[1] 王武星 宋劲松[1] WU Peng;QIN Shu;XU Wei;WANG Wuxing;SONG Jinsong(The First People's Hospital of Tianmen City,Hubei Province,Tianmen 431700,China)

机构地区：[1]湖北省天门市第一人民医院,湖北天门431700 [2]西南医科大学附属医院

出　　处：《中国医学创新》2023年第9期121-125,共5页Medical Innovation of China

基　　金：核医学与分子影像四川省重点实验室开放课题(HYX18025)。

摘　　要：目的:探讨吲哚菁绿分子荧光显像在腹腔镜下复杂胆囊切除术中临床应用价值。方法:回顾性分析天门市第一人民医院同一术者2019年1月-2022年1月行腹腔镜下复杂胆囊切除术78例患者的临床资料。术前7 h经静脉注射吲哚菁绿2.5 mg的患者设为试验组(n=42),未注射的患者设为对照组(n=36)。比较两组患者术中胆囊管识别率、肝总管识别率、胆总管识别率、解剖出胆囊三角时间、手术时间、术中出血量、中转开腹率及并发症(胆道损伤、术后胆瘘)发生率。结果:所有患者均完成手术,无死亡病例。解剖胆囊三角前,试验组患者胆囊管识别率为76.19%(32/42),肝总管识别率为69.05%(29/42),胆总管识别率为83.33%(35/42),对照组患者胆囊管识别率为33.33%(12/36),肝总管识别率为19.44%(7/36),胆总管识别率为25.00%(9/36),两组术中胆囊管、肝总管、胆总管识别率比较,差异均有统计学意义(P<0.05)。试验组解剖出胆囊三角时间、手术时间分别为(25.34±7.25)、(38.37±11.26)min,均短于对照组的(38.56±8.86)、(61.47±15.96)min,术中出血量为(15.78±6.46)mL,少于对照组的(27.39±18.49)mL(P<0.05)。试验组无中转开腹、胆道损伤及术后胆瘘病例,对照组2例中转开腹、胆总管损伤及右肝管损伤各1例、术后胆瘘1例,试验组并发症发生率低于对照组(χ^(2)=13.450,P=0.032)。结论:吲哚菁绿分子荧光显像在腹腔镜下复杂胆囊切除术中有助于识别胆囊三角、缩短手术时间、减少手术并发症发生率,有较好的临床价值。Objective:To investigate the clinical value of Indocyanine Green molecular fluorescence image in laparoscopic complicated cholecystectomy.Method:The clinical data of 78 patients who underwent laparoscopic complicated cholecystectomy in the First People's Hospital of Tianmen City from January 2019 to January 2022 were retrospectively analyzed.Patients who received intravenous Indocyanine Green 2.5 mg 7 h before surgery were selected as experimental group(n=42),and those who did not received intravenous Indocyanine Green were selected as control group(n=36).The rates of intraoperative identification of gallbladder duct,hepatic duct and common bile duct,the time of dissection of gallbladder triangle,operation time,intraoperative blood loss,conversion to laparotomy rates and incidence of complications(biliary tract injury and postoperative biliary fistula)were compared between the two groups.Result:All patients underwent surgery without death.Before dissecting the gallbladder triangle,the identification rates of gallbladder duct,hepatic duct and common bile duct in experimental group was 76.19%(32/42),69.05%(29/42),83.33%(35/42),respectively.And in control group,the identification rates of gallbladder duct was 33.33%(12/36),hepatic duct recognition rate was 19.44%(7/36)and common bile duct recognition rate was 25.00%(9/36).There were statistically significant differences in the identification rates of gallbladder duct,hepatic duct and common bile duct between the two groups(P<0.05).The triangulation time,operation time of the experimental group were(25.34±7.25)min,(38.37±11.26)min,respectively,which were shorter than(38.56±8.86)min,(61.47±15.96)min of the control group,intraoperative blood loss of the experimental group was(15.78±6.46)mL,

关 键 词：荧光腹腔镜 吲哚菁绿 胆囊切除术 

分 类 号：R657.4[医药卫生—外科学]