ICG荧光腹腔镜下胆囊切除术的临床应用  

Clinical application of ICG fluorescence laparoscopic cholecystectomy

作　　者：王兴 文阳辉 姚戈冰 郭平学 杨自华[1] Wang Xing;Wen Yanghui;Yao Gebing;Guo Pingxue;Yang Zihua(Department of Hepatobiliary,the Second Afiliated Hospital of Xi'an Medical College,Xi'an Shaanxi Province 710038,China)

机构地区：[1]西安医学院第二附属医院肝胆外科,西安710038

出　　处：《中华普外科手术学杂志（电子版）》2024年第6期663-666,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：陕西省重点研发计划项目(2021SF-093)。

摘　　要：目的探讨吲哚菁绿(ICG)荧光显像引导下的腹腔镜胆囊切除术(LC)对胆囊结石伴胆囊炎患者的影响。方法前瞻性纳入2021年1月至2023年1月83例行LC的胆囊结石伴胆囊炎患者作为研究对象。用随机数字表法分为ICG组(n=42例)与常规组(n=41例)。常规组采用LC治疗,ICG组采用ICG荧光显像引导下的LC治疗。数据采用SPSS27.0分析,围手术期指标等计量数据用(χ±s)描述,采用独立样本t检验;术后并发症等计数资料用[例(%)]表示,行χ^(2)检验。P<0.05为差异有统计学意义。结果ICG组第一次探查到胆总管、肝总管,胆囊管均高于常规组[(69.1% vs. 26.8%,59.5% vs. 31.7%),P<0.05];ICG组完全解剖后探查到胆总管、肝总管高于常规组[(90.5% vs. 68.3%,90.5% vs. 85.4%),P<0.05];ICG组患者术中出血量、手术时间、胆囊三角完全解剖所需时间、术后住院时间、胃肠功能恢复时间均短于常规组(P<0.05),两组患者术中胆管损伤率和术后并发症发生率比较,差异无统计学意义(P>0.05)。结论ICG荧光显像引导下的腹腔镜胆囊切除术可减轻免疫损伤,提高胆总管、肝总管、胆囊管探查率,减少术中出血量。Objective To investigate the effect of indocyanine green(ICG)fluorescence imaging guided laparoscopic cholecystectomy(LC)on patients with gallstones and cholecystitis.Methods83 patients with gallstones and cholecystitis who underwent LC from January 2021 to January 2023 were prospectively included as study subjects.They were divided into ICG group(n=42 cases)and conventional group(n=41 cases)by random number table method.The conventional group was treated with LC,and the ICG group was treated with LC guided by ICG fluorescence imaging.Data were analyzed by SPSS27.0,measurement data such as perioperative indicators were described by(χ±s),and independent sample t test was used.The statistical data of postoperative complications were expressed with[cases(%)]and Chi-square test was performed.P<0.05 was considered statistically significant.Results The first detection of common bile duct,hepatic duct and gallbladder duct in ICG group was higher than that in conventional group[(69.1%us.26.8%,59.5%vs.31.7%),P<0.05].After complete dissection,the common bile duct and hepatic duct in ICG group were higher than those in conventional group[(90.5%us.68.3%,90.5%us.85.4%),P<0.05].The amount of intraoperative blood loss,operation time,total dissection time of gallbladder triangle,postoperative hospitalization time and gastrointestinal function recovery time in ICG group were all shorter than those in conventional group(P<0.05).There was no significant difference in the rate of intraoperative bile duct injury and postoperative complications between the two groups(P>0.05).Conclusion ICG fluorescence imaging guided laparoscopic cholecystectomy can reduce immune damage,improve the exploration rate of common bile duct,hepatic duct and gallbladder duct,and reduce intraoperative blood loss.

关 键 词：胆囊结石 胆囊炎 腹腔镜胆囊切除术 吲哚菁绿荧光显像 

分 类 号：R657.4[医药卫生—外科学]