吲哚菁绿荧光胆道造影技术应用于困难型腹腔镜胆囊切除术的Meta分析
A meta-analysis of indocyanine green fluorescent cholangiography applied in difficult laparoscopic cholecystectomy
石明炜 1张鑫 1王鑫 2闫军3
作者信息
- 1. 山西医科大学第一临床医学院,山西 太原,030001
- 2. 山西医科大学第一医院泌尿外科
- 3. 山西医科大学第一医院肝胆胰外科
- 折叠
摘要
目的:评价吲哚菁绿荧光胆道造影技术应用于困难型腹腔镜胆囊切除术的有效性.方法:检索中国知网、维普数据库、PubMed、Web of Science等数据库建库至2023 年6 月的相关文献,按照纳入与排除标准进行筛选后,对纳入的文献进行资料提取与质量评价,采用RevMan 5.4 软件进行Meta分析.结果:共纳入 24 篇文献.Meta分析结果显示,吲哚菁绿组识别胆道结构时间(MD=-14.28,95%CI=-19.42～-9.14,P＜0.05)、手术时间(MD=-19.56,95%CI=-24.39～-14.72,P＜0.05)、术后住院时间(MD=-0.69,95%CI=-1.03～-0.36,P＜0.05)、术后引流时间(MD=-0.78,95%CI=-1.17～-0.38,P＜0.05)短于传统组,胆管损伤率(OR=0.22,95%CI=0.11～0.44,P＜0.05)、中转开腹率(OR=0.40,95%CI=0.22～0.72,P＜0.05)、术后并发症发生率(OR=0.42,95%CI=0.28～0.65,P＜0.05)低于传统组,术中失血量(MD=-17.97,95%CI=-24.67～-11.26,P＜0.05)少于传统组,解剖前肝总管(OR=8.41,95%CI=4.65～15.21,P＜0.05)、胆囊管(OR=4.21,95%CI=2.80～6.33,P＜0.05)、胆总管(OR=9.64,95%CI=6.02～15.44,P＜0.05)识别率均高于传统组.结论:吲哚菁绿荧光胆道造影技术为困难的腹腔镜胆囊切除术提供了新的胆道显影方式,可提高手术安全性,减少术中副损伤及术后并发症的发生.
Abstract
Objective:To evaluate the effectiveness of indocyanine green(ICG)fluorescence cholangiography in difficult lapa-roscopic cholecystectomy(LC).Methods:Relevant literatures were retrieved from databases such as China national knowledge infra-structure,VIP,PubMed,and Web of Science from their establishment until Jun.2023.After screening according to inclusion and exclu-sion criteria,data extraction and quality evaluation of the included literatures,meta-analysis was performed using RevMan 5.4 statistical software.Results:A total of 24 studies were included in the meta-analysis.The meta-analysis results showed that compared with the conventional group,the ICG group in difficult LC had significantly shorter time for identification of biliary structure(MD=-14.28,95%CI=-19.42～-9.14,P＜0.05),shorter operation time(MD=-19.56,95%CI=-24.39～-14.72,P＜0.05),shorter post-operative hospital stay(MD=-0.69,95%CI=-1.03～-0.36,P＜0.05),shorter postoperative drainage time(MD=-0.78,95%CI=-1.17～-0.38,P＜0.05),lower incidence of bile duct injury(OR=0.22,95%CI=0.11～0.44,P＜0.05),lower rate of conversion to open surgery(OR=0.40,95%CI=0.22-0.72,P＜0.05),lower incidence of postoperative complications(OR=0.42,95%CI=0.28～0.65,P＜0.05),less intraoperative blood loss(MD=-17.97,95%CI=-24.67～11.26,P＜0.05),and higher identification rates of the common hepatic duct(OR=8.41,95%CI=4.65～15.21,P＜0.05),cystic duct(OR=4.21,95%CI=2.80～6.33,P＜0.05),and common bile duct(OR=9.64,95%CI=6.02～15.44,P＜0.05)before anatomy.Conclusions:ICG fluorescence cholangiography pro-vides a new method for biliary visualization in the difficult LC.It has the potential to improve the safety of difficult LC and reduce the incidence of intraoperative side-injury and postoperative complications.
关键词
胆囊切除术,腹腔镜/困难/吲哚菁绿/荧光胆道造影/Meta分析Key words
Cholecystectomy,laparoscopic/Difficult/Indocyanine green/Fluorescence cholangiography/Meta-analysis引用本文复制引用
基金项目
山西省青年科学研究项目(20210302124611)
山西省留学人员科技活动择优资助项目(20210005)
出版年
2024
国家科技期刊平台
NSTL
万方数据