吲哚菁绿荧光成像在复杂腹腔镜胆囊切除术中的应用OACSTPCD

Objective:To explore the clinical application value and preliminary experience of the indocyanine green (ICG) in complex laparoscopic cholecystectomy (LC). Methods:Clinical data of 70 patients who suffered from acute cholecystitis or a history of upper abdominal surgery and underwent LC using ICG from Jun. 2021 to Mar. 2022 were retrospectively analyzed. All patients were administered intravenously 5 mg ICG and divided into a long-term group (8～12 h before operation) and a short-term group (0. 5～1 h before operation) according to the time of administration. The general condition,laboratory results,intraoperative fluorescence visualization and operation time of the patients were analyzed. Results:The two groups showed no significant differences in sex,age,body mass index,American society of anesthesiologists score and laboratory results. In the 70 patients,40 (57. 1％) showed the cholecystic duct and 65 (92. 9％) showed the common bile duct. No significant differences were found between the two groups in the rates of gallbladder visualization,cystic duct visualization and common bile duct visualization (P>0. 05). The visualization rate of the liver in the short-term group was better than that in the long-term group (P<0. 001). No significant differences were found between the two groups in the operation difficulty score and total operation time (P>0.05). There were no statistical differences in gallbladder triangle exposure time (P=0. 765) between the two groups,whereas the gallbladder bed dissection time in the short-term group was shorter than that in the longterm group (P=0. 026). Conclusions:ICG-assisted complex LC can visualize the common bile duct better than the cystic duct. It has an obvious guiding role in the anatomy of gallbladder triangle. The administration 0. 5～1 h before operation is better in the visualization of the liver and the dissection of the gallbladder from the liver bed. So maybe the short duration of administration is more suitable for complex LC.