吲哚菁绿荧光腔镜导航在困难型胆囊切除术中的应用研究

Application of Indocyanine Green Fluorescent Endoscopic Navigation in Difficult Cholecystectomy

摘要: 目的：研究吲哚菁绿(Indocyanine green, ICG)荧光腔镜导航在困难型腹腔镜胆囊切除术(Laparoscopic cholecy stectom, LC)中的临床应用价值。方法：回顾性分析搜集2022年5月至2023年6月于山一大二附院行困难型腹腔镜胆囊切除手术患者的临床病例资料55例，55例患者按顺序随机入组，其中27例患者采用传统腹腔镜手术(对照组A组)，28例采用吲哚菁绿腔镜手术(实验组B组)。分析两组患者年龄、性别、BMI、合并基础疾病等一般资料；分析两组患者年龄、性别、BMI、合并基础疾病等一般资料，以及术中出血量、手术时间、术后排气时间、术后拔管时间、术后住院天数、住院总费用、术后并发症等各数据间的差异。本研究采用SPSS 25.0软件分析，计量资料利用均数 ± 平均差( )的形式呈现，以独立样本t检验进行比较；计数资料经X2检验处理。若p < 0.05，说明各指标间存在显著区别，差异有统计学意义。结果：A组与B组相比，其手术时间和术中出血量经卡方检验(p < 0.05)，差异有统计学意义；其余数据指标差异无统计学意义(p > 0.05)。结论：ICG应用于困难型腹腔镜胆囊切除术中，其优势效果明显，有利于局部解剖暴露清晰，提高术中安全性，可以缩短手术时间，减少术中出血量。

Abstract: Objective: To study and explore the clinical application value including feasibility, safety, and sta-bility of indocyanine green (ICG) fluorescence endoscopic navigation in difficult laparoscopic chole-cystectomy (LC). Method: Retrospective analysis and collection of data from May 2022 to June 2023 at Shanyi University and Erfu University Clinical case data of 55 patients undergoing difficult lapa-roscopic cholecystectomy in the hospital. 55 patients were randomly enrolled in order, including 27 patients that traditional laparoscopic surgery was used (control group A), and 28 cases were treat-ed with indocyanine green laparoscopic surgery (experimental group B). Analyzing the age, gender, and General information such as BMI and comorbid underlying diseases; Intraoperative and post-operative, especially the differences in: intraoperative bleeding volume, surgical time, postopera-tive exhaust time, postoperative extubation time, postoperative hospitalization days, total hospital-ization costs, postoperative complications and the other data. This study used SPSS 25.0 software for analysis, and the econometric data was presented in the form of mean ± mean difference ( ) for comparison using independent sample t-tests; The counting data was processed through X2 test. If p < 0.05, it indicates significant differences between various indicators, with statistical signifi-cance. Result: Group A and Group B were compared through chi square test. Group B has shorter surgical time and less bleeding volume. The difference is statistically significant (p < 0.05), no sig-nificant difference in other indicators compared (p > 0.05). Conclusion: In difficult laparoscopic cholecystectomy, ICG has obvious advantages and effects, which is beneficial for clear local anatom-ical exposure, improving intraoperative safety, shortening surgical time, and reducing intraopera-tive bleeding.