摘要
Abstract
Objective To investigate the feasibility and the clinical value of magnetic resonance cholangiopancreatography(MRCP)combined with indocyanine green(ICG)near infrared fluorescence imaging cholangiography in the identification of bile duct in gallbladder bed.Methods The clinical data of 160 patients,who undergwent laparoscopic cholecystectomy(LC)with intraoperative fluorescence cholangiography(the study group)between Jul.2021 and Dec.2023 in Zibo Municipal Hospital,were retrospectively analyzed.Additionally,the clinical data of 180 patients who underwent LC with traditional laparoscopic standard white light mode between Jan.2020 and Dec.2023(control group),were retrospectively collected,and the intraoperative and postoperative indicators between the two groups were compared.Results There was no statistically significant difference in intraoperative blood loss between the two groups[(10.3±1.7)mL vs(11.9±1.4)mL,P>0.05].Operation time in the study group was shorter than that in the control group[(30.6±10.3)min vs(45.7±9.6)min,P<0.05].The bile duct in gallbladder bed was found in 12(7.5%)patients in the study group by intraoperative fluorescence imaging cholangiography.There was 1 case of bile duct injury in gallbladder bed in study group,which was addressed with intraoperative suturing,and bile leakage didn't occur after surgery.There were 2 cases of duct leakage in gallbladder bed in the control group,which was confirmed by endoscopic retrograde cholangiopancreatography(ERCP).The hospitalization time in the study group was shorter than that in the control group[2.0(1.0,2.0)d vs 3.0(2.0,4.0)d,P<0.05],and the catheterization rate in the study group was lower than that in the control group[2.50%(4/160)vs 8.33%(15/180),P<0.05].There was no statistically significant difference in postoperative biliary leakage incidence rate and catheterization time between the two groups(all P>0.05).The sensitivity and specificity of MRCP for diagnosing the bile duct in gallbladder bed were 58.3%and 61.0%respectively.Conclusion Preoperative MRCP evaluation and intraoperative application of ICG fluorescence imaging in LC can help to shorten the operation time,improve the,operation safty,and reduce the postoperative complication.关键词
磁共振胰胆管成像/荧光胆道造影/吲哚菁绿/腹腔镜胆囊切除术/胆囊床胆管/胆漏Key words
magnetic resonance cholangiopancreatography/fluorescence cholangiography/indocyanine green/laparoscopic cholecystectomy/bile duct in gallbladder bed/bile leakage分类
医药卫生
