摘要
Abstract
Objective To investigate the application value of ultra-low fixed dose indocyanine green(ICG)fluorescence navigation technology in laparoscopic difficult cholecystectomy.Methods A retrospective analysis was performed on the clinical data of 134 patients who underwent laparoscopic difficult cholecystectomy in Xianju People's Hospital by a single medical team between January 2024 and January 2025.Depending on whether ICG fluorescence navigation was implemented,134 patients were divided into the ICG group[n=77,preoperative peripheral intravenous injection of ICG(0.05 mg/mL,1 mL)]and the control group(n=57,conventional laparoscopic cholecystectomy).Time to distinguish the three ducts(cystic duct,common hepatic duct,common bile duct),operation time,intraoperative blood loss,intraoperative drainage tube placement,intraoperative bile duct injury,postoperative time to extubation,postoperative complications,postoperative time of hospital stay,total hospitalization cost,and levels of white blood cell(WBC)count,C-reactive protein(CRP),alanine aminotransferase(ALT),and gamma-glutamyl transferase(GGT)on the first day after surgery were compared between the two groups.Results Compared with the control group,the ICG group demonstrated a shorter time to identify three ducts[(30.4±13.9)min vs(38.4±12.9)min],lower intraoperative blood loss[(17.4±10.0)mL vs(21.6±11.7)mL],shorter operation time[(56.9±19.6)min vs(64.0±16.9)min]and shorter time of postoperative hospital stay[2(2,3)d vs 3(3,4)d],the differences were all significant(P<0.05).No significant difference was observed between the two groups in terms of intraoperative drainage tube placement,intraoperative bile duct injury,levels of WBC count,CRP,ALT,and GGT on the first day after surgery,postoperative time to extubation,postoperative complications or total hospitalization cost(P>0.05).Conclusion The application of ultra-low fixed dose ICG fluorescence navigation technology in laparoscopic difficult cholecystectomy is safe and feasible.It improves the identification rate of gallbladder duct,common hepatic duct and common bile duct,reduces intraoperative bleeding,shorten operation time and postoperative time of hospital stay.关键词
腹腔镜胆囊切除术/吲哚菁绿/荧光导航/超低固定剂量/胆囊管/肝总管/胆总管/术中胆管损伤Key words
laparoscopic cholecystectomy/indocyanine green/fluorescence navigation/ultra-low fixed dose/gallbladder duct/common hepatic duct/common bile duct/intraoperative bile duct injury分类
医药卫生
