摘要
目的比较吲哚菁绿荧光胆管造影(ICG)联合腹腔镜胆囊切除术(LC)与常规LC在复杂性LC中的有效性及安全性。方法通过检索库检索2018—2022年,ICG荧光胆管造影LC试验组与常规LC对照组在复杂性LC疗效比较的研究,纳入的文献进行质量评估并提取相关研究数据后,使用RevMan Manager 5.4进行meta分析。结果本研究最终纳入14篇相关文献,含1116份病例资料。经分析后发现,与常规LC治疗组相比,ICG联合LC组手术时间短(MD=-24.37,95%CI:-32.87~-15.86),术中出血量少(MD=-11.36,95%CI:-15.34~-7.37),术中胆道结构识别时间短(MD=-16.79,95%CI:-31.00~-2.58),术后住院时间短(MD=-0.61,95%CI:-1.13~-0.09),术后肛门排气功能恢复时间短(MD=-2.61,95%CI:-5.40~-0.17),术后并发症总发生率低(OR=0.57,95%CI:0.16~0.44),住院花费少(MD=-1549.69,95%CI:-2647.34~-452.04);两组术后拔除引流管时间和术中中转开腹率比较,差异无统计学意义(P>0.05)。结论复杂性胆囊疾病行LC中,ICG胆管造影可降低对胆道损伤的风险且安全有效。
Objective To compare the efficacy and safety of indocyanine green(ICG)fluorescence cholangiography combined with laparoscopic cholecystectomy(LC)and conventional LC in the treatment of complicated LC.Methods Through the retrieval database,studies comparing the efficacy of ICG fluorescence cholangiography LC test group and conventional LC control group in complex LC from 2018 to 2022 were retrieved.After the quality of the included literature was evaluated and the relevant research data were extracted,RevMan Manager 5.4 was used for meta-analysis.Results A total of 14 articles were included in this study,including 1116 cases.The analysis showed that compared with the conventional LC treatment group,the ICG combined LC group had shorter operation time(MD=-24.37,95%CI:-32.87 to-15.86)and less intraoperative blood loss(MD=-11.36,95%CI:-15.34 to-7.37),shorter time to recognize biliary structure(MD=-16.79,95%CI:-31.00 to-2.58),shorter postoperative hospital stay(MD=-0.61,95%CI:-1.13 to-0.09),shorter recovery time of anal exhaust function(MD=-2.61,95%CI:-5.40 to-0.17),lower total incidence of postoperative complications(OR=0.57,95%CI:0.16 to-0.44),and less hospitalization costs(MD=-1549.69,95%CI:-2647.34 to-452.04).There were no significant differences in postoperative drainage tube removal time and intraoperative conversion rate between the two groups(P>0.05).Conclusion ICG cholangiography is safe and effective in LC for complex gallbladder diseases,which can reduce the risk of bile duct injury.
作者
武林得
涂勇浪
高国华
李刚
WU Linde;TU Yonglang;GAO Guohua;LI Gang(Department of Hepatobiliary Surgery,the First Affiliated Hospital of Kunming Medical University,Yunnan Province,Kunming650032,China;Department of General Surgery,Yunnan Maternal and Child Health Care Hospital,Yunnan Province,Kunming650051,China)
出处
《中国当代医药》
CAS
2024年第11期14-19,24,共7页
China Modern Medicine
基金
云南省妇幼保健院妇幼健康研究项目(FYJK2022-02)。
