Clinical Application of Laparoscopic Cholecystectomy with Fluorescence Cholangiography of Indocyanine Green in the Difficult Cholecystectomy

Cheng ZHANG; Ning XU; Weisi LI; Yuntao ZHU; Min SUN

doi:10.12259/j.issn.2095-610X.S20220222

Volume 43 Issue 2

Mar. 2022

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Article Navigation > Journal of Kunming Medical University > 2022 > 43(2): 134-140

Cheng ZHANG, Ning XU, Weisi LI, Yuntao ZHU, Min SUN. Clinical Application of Laparoscopic Cholecystectomy with Fluorescence Cholangiography of Indocyanine Green in the Difficult Cholecystectomy[J]. Journal of Kunming Medical University, 2022, 43(2): 134-140. doi: 10.12259/j.issn.2095-610X.S20220222

Citation:

Cheng ZHANG, Ning XU, Weisi LI, Yuntao ZHU, Min SUN. Clinical Application of Laparoscopic Cholecystectomy with Fluorescence Cholangiography of Indocyanine Green in the Difficult Cholecystectomy[J]. Journal of Kunming Medical University, 2022, 43(2): 134-140. doi: 10.12259/j.issn.2095-610X.S20220222

Citation:

Cheng ZHANG, Ning XU, Weisi LI, Yuntao ZHU, Min SUN. Clinical Application of Laparoscopic Cholecystectomy with Fluorescence Cholangiography of Indocyanine Green in the Difficult Cholecystectomy[J]. Journal of Kunming Medical University, 2022, 43(2): 134-140. doi: 10.12259/j.issn.2095-610X.S20220222

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Clinical Application of Laparoscopic Cholecystectomy with Fluorescence Cholangiography of Indocyanine Green in the Difficult Cholecystectomy

doi: 10.12259/j.issn.2095-610X.S20220222

The 2nd Affiliated Hospital of Kunming Medical University，Kunming Yunnan 650101，China

Received Date: 2021-12-09
Available Online: 2022-02-24
Publish Date: 2022-03-04

Abstract

Abstract

Objective To study the safety, feasibility and reliability of indocyanine green fluorescence staining in laparoscopic cholecystectomy, whether it can effectively avoid bile duct injury, and to explore the shortcomings and advantages of indocyanine green fluorescence laparoscopic technology in difficult cholecystectomy. Methods The method of retrospective analysis was adopted, and the clinical data of patients meeting inclusion criteria for difficult cholecystectomy in 65 cases of cholecystectomies with the causes of the gallstone and recurrent cholecystitis in The Second Affiliated Hospital of Kunming Medical University from December 1, 2018 to December 1, 2019 were collected. All patients had signed the informed consent and had no history of iodine allergy. 65 patients were assigned randomly with 35 cases of laparoscopic cholecystectomy （LC） and 30 cases of laparoscopic cholecystectomy （LC） with fluorescence cholangiography of indocyanine green （ICG）. All kinds of the preoperative, intraoperative and postoperative data were collected to compare between the conventional group and cholangiography group. The application effect, safety and feasibility of the laparoscopic technologies with fluorescence cholangiography in the difficult cholecystectomy were explored, including whether the anatomic structure of the bile duct and the biliary tract time can be identified effectively. Results The time of laparoscopic cholecystectomy （LC） group was significantly longer than that of fluorescence cholangiography group （P < 0.05）; in terms of the time to isolate the anatomy of biliary tract, the time of fluorescence cholangiography group was significantly shorter than that of laparoscopic cholecystectomy （LC） group （P < 0.05）; the amount of bleeding in laparoscopic cholecystectomy （LC） was no statistically significant combined with fluorescence cholangiography group （P > 0.05）; there was no significant difference in length of stay （LOS） and all-in cost of stay between the two groups （P > 0.005）. Conclusions Indocyanine green fluorescence imaging laparoscopy has high operability and strong safety in identifying the anatomical structure of biliary tract in difficult cholecystectomy. It can effectively identify the anatomical structure of gallbladder triangle and effectively avoid the injury of biliary tract and blood vessels; Indocyanine green fluorescence imaging laparoscopic technology has the advantage of short operation time compared with traditional laparoscopic technology in Difficult Cholecystectomy, and there is no significant difference in postoperative liver function, infection index, hospitalization cycle and total hospitalization cost.
- Indocyanine green,
- Laparoscopic cholecystectomy,
- Biliary tract injury

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References(18)

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