Objective To analyze the clinical value of indocyanine green(ICC)fluorescence ima-ging in Mirizzi syndrome type Ⅱ-Ⅲ laparoscopic cholecystectomy(LC).Methods A retrospective analy-sis was performed on 80 patients diagnosed with Mirizzi syndrome types Ⅱ-Ⅲ who underdoing LC in Affilia-ted Hospital of Liaoning University of Traditional Chinese Medicine from October 2018 to February 2022,in-cluding 32 males and 48 females,aged(63.5±6.9)years.Patients were divided into two groups based on whether ICG fluorescence imaging technology was used,the control group(n=38)that patients were treated with conventional LC and the experimental group(n=42)patients were treated with LC guided by ICG fluo-rescence imaging.In the experimental group,the extrahepatic bile duct was identified by ICG fluorescence imaging during LC,and ICG was injected intraoperally to determine the reserved blood flow of gallbladder flap for fluorescence imaging and determine the resection line.Operation time,intraoperative blood loss,conversion rate of laparotomy and postoperative complications(bile leakage,incision infection,etc.)were compared between the two groups.Intraoperative fluorescence imaging and determination of the modified re-section line of reserved gallbladder were analyzed in the observation group.Results There was no signifi-cant difference in age,male proportion,type of Mirizzi syndrome and conversion rate of laparotomy between the two groups(all P＞0.05).In the observation group,the operative time was(208.7±32.0)min,the intraoperative blood loss was(50.5±23.8)ml,and the biliary leakage was 7.1％(3/42),which was low-er than that in the control group(228.2±33.9)min,(73.8±31.0)ml,26.3％(10/38).The differ-ences were statistically significant(all P＜0.05).Of 37 cases(88％)showed common hepatic duct and common bile duct successfully in the observation group.In the observation group,ICG fluorescence imaging was used to determine the gallbladder resection line in 8 cases(19.0％).The gallbladder flap without fluo-rescence imaging was removed.Conclusion ICG fluorescence imaging in LC for Mirizzi syndrome patients can identify the common bile duct and hepatic duct to guide surgical resection,determine the gallbladder flap resection line,reduce postoperative bile leakage and bleeding,and accelerate the surgical progress.
Mirizzi syndromeCholecystectomy,laparoscopicIndocyanine green fluorescence imagingBile leakage
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