Objective:To investigate the application value of transnasal biliary tract indocyanine green(ICG)navigation in sequential laparoscopic cholecystectomy(LC)after endoscopic duodenal papillary sphincter subtotal incision balloon dilatation(ES-BD)in the treatment of elderly patients with bile duct calculi.Methods:Sixty elderly patients with cholecystolithiasis accompanied by choledocholithiasis admitted from Jan.2020 to Jan.2023 were selected to adopt the treatment plan of sequential LC with ESBD,and they were divided into the conventional group(n=30)and the navigation group(n=30)according to whether or not ICG was injected via the nasobiliary duct for intraoperative navigation during LC,and the relevant clinical data were collected and statistically analyzed.Results:There was no significant difference in the general information of patients in the two groups,and ESBD sequential LC was su-ccessfully performed for all patients.Two cases of abnormal bile duct type in the hepatoportal area were confirmed intraoperatively in the navigation group,and there was no intraoperative conversion to laparotomy and no bile duct injury.Surgical time[(68.43±27.40)min vs.(63.17±23.25)min],intraoperative blood loss[(12.37±5.53)mL vs.(11.03±4.66)mL]and postoperative hospital stay[(4.90±0.99)d vs.(4.77±0.94)d]after LC in the conventional group and navigation group were not significantly different(P>0.05).Postoperative cystic duct stump length found by nasal cholangiography[(10.67±2.61)mm vs.(5.87±2.47)mm]was signifi-cantly different(P<0.01).Conclusions:Intraoperative navigation using ICG injection through transnasal bile duct has the advantage of no background interference over conventional intravenous injection ICG,it can more clearly show the relationship between the hepatopor-tal bile ducts and confirm the biliary abnormalities type,and it can reduce the postoperative discomfort caused by the excessive length of cystic duct stump,which is of positive clinical significance in improving the safety of sequential LC after ESBD in elderly patients.
关键词
胆管结石/吲哚菁绿/内镜十二指肠乳头括约肌小切开球囊扩张术/胆囊切除术,腹腔镜/老年人
Key words
Cholangiolithiasis/Indocyanine green/Endoscopic small incision and balloon dilatation of papillary sphincter/Cholecystectomy,laparoscopic/Aged
维普
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