吲哚菁绿荧光技术在腹腔镜复杂胆囊切除术中的临床应用  

Clinical application of indocyanine green fluorescence technique in laparoscopic complex cholecystectomy

作　　者：黄宜锋 谢建森 贺更生 HUANG Yifeng;XIE Jiansen;HE Gengsheng(Department of Hepatobiliary Surgery,Longhua District People's Hospital of Shenzhen,Shenzhen 518109,China)

机构地区：[1]深圳市龙华区人民医院肝胆外科,广东深圳518109

出　　处：《腹腔镜外科杂志》2023年第11期836-840,共5页Journal of Laparoscopic Surgery

摘　　要：目的:探讨吲哚菁绿(ICG)荧光导航在腹腔镜复杂胆囊切除术中的应用价值。方法:回顾分析2021年10月至2022年9月为89例复杂胆囊患者行腹腔镜胆囊切除术的临床资料,根据是否使用ICG荧光分为使用ICG荧光显影的A组(n=44)与未使用荧光显影的B组(n=45)。比较两组胆囊三角解剖时间、显露肝外胆管电钩使用时间、剥离胆囊床时间、总手术时间、胆管损伤、手术出血量等相关指标。结果:A组与B组胆囊三角解剖时间[(24.26±5.64)min vs.(32.54±4.32)min,P<0.05]、显露肝外胆管电钩使用时间[(16.06±3.52)min vs.(23.78±4.97)min,P<0.05]、分离胆囊床时间[(10.15±2.24)min vs.(7.08±1.92)min,P<0.05]、总手术时间[(72.35±3.34)min vs.(85.15±4.71)min,P<0.05]、手术出血量[(10.43±4.91)mL vs.(21.58±3.73)mL,P<0.05]差异有统计学意义,两组均未发生胆管损伤。结论:对于腹腔镜复杂胆囊切除术,吲哚菁绿荧光导航技术利于辨识肝外胆管,明确脉管与组织间隙,可缩短手术时间、减少术中出血量。Objective:To investigate the application value of indocyanine green(ICG)fluorescence navigation in laparoscopic complex cholecystectomy.Methods:The clinical data of 89 patients with complex gallbladder who underwent laparoscopic cholecystec-tomy from Oct.2021 to Sep.2022 were retrospectively analyzed.According to whether ICG fluorescence was used,patients were divided into group A(with ICG fluorescence,n=44)and group B(without ICG fluorescence,n=45).The anatomical time of the gallbladder triangle,time of the electric hook used for exposure of the extrahepatic bile duct,the separation time of the gallbladder bed,the total o peration time,bile duct injury and operative blood loss were compared between the two groups.Results:The differences were statistically significant between group A and group B in anatomical time of gallbladder triangle[(24.26±5.64)min vs.(32.54±4.32)min,P<0.05],the time for exposure of extrahepatic bile duct using electric hook[(16.06±3.52)min vs.(23.78±4.97)min,P<0.05],the time for separation of gallbladder bed[(10.15±2.24)min vs.(7.08±1.92)min,P<0.05],total operative time[(72.35±3.34)min vs.(85.15±4.71)min,P<0.05],and operative blood loss[(10.43±4.91)mL vs.(21.58±3.73)mL,P<0.05],and no bile duct injury occurred in both groups.Conclusions:For laparoscopic complex cholecystectomy,ICG fluorescence navigation technology is beneficial to identification of the extrahepatic bile duct,definition of the vasculature and tissue space,reduction of the operative time and intraoperative blood loss.

关 键 词：胆囊切除术 腹腔镜 复杂 吲哚菁绿 荧光导航 

分 类 号：R657.4[医药卫生—外科学]