关键词: 胆囊结石, 腹腔镜胆囊切除术, 吲哚青绿, 胆道造影, 治疗

Abstract: Objective The aim of this study was to investigate the application of laparoscopic cholecystectomy (LC) under guidance of indocyanine green (ICG) near infrared fluorescence in treatment of patients with gallstones. Methods 172 patients with gallstones were consecutively encountered in our hospital between March 2019 and August 2022, and were randomly divided into two control and observation groups, with 86 cases in each group. The patients in the control group received routine LC, and those in the observation underwent LC under the guidance of ICG cholangiography. All patients after operation were followed-up and univariate and multivariate Logistic regression analysis was applied to reveal the impacting factors for complications after operation. Results The operation time, blood loss and hospitalization stay in the observation group were(38.4±3.8)min,(65.1±6.4)mL and (4.6±0.4)day, all significantly shorter or less than [(49.7±4.7)min,(85.3±8.4)mL and (6.5±0.7)day, respectively, P<0.05] in the control; the rate of post-operational complication, such as biliary injury, rupture of ductus cysticus, biliary infection, peritoneal infection and stone residue, in the observation group was 4.6%, much lower than 15.1% in the control (P<0.05); out the 172 patients with gallstone in our series, the post-operational complications occurred in 17 cases, and the elderly patients, obviously increased body mass index, concomitant diabetes mellitus, chronic cholecystitis history, relatively large amount of blood loss and no ICG radiography in the patients with complications were 70.6%, 52.9%, 64.7%, 94.1%, 76.5% and 0.0%, significantly different compared to 34.8%, 27.7%, 37.4%, 62.6%, 47.1% and 72.9% in patients without complications (P<0.05); the multivariate Logistic regression analysis showed that the ages, concomitant diabetes, blood loss and ICG radiography were the independent factors related to the occurrence of post-operational complications(all P<0.05). Conclusion The application of LC under the guidance of ICG near infrared fluorescence cholangiography in the treatment of patients with gallstone could reduce the amount of intraoperative blood loss and the incidence of postoperative complications, which warrants further clinical multi-central validation.

Key words: Gallstone, Laparoscopic cholecystectomy, Indocyanine green, Cholangiography, Therapy