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吲哚菁绿(ICG)成像辅助胆囊切除术对术中及术后并发症的影响:一项荟萃分析。

Effects of Indocyanine Green (ICG) Imaging-Assisted Cholecystectomy on Intraoperative and Postoperative Complications: A meta-Analysis.

作者信息

Tang Yuhong, Liu Renjie, Liu Huanxiang, Peng Rui, Su Bingbing, Tu Daoyuan, Wang Shunyi, Chen Chen, Jiang Guoqing, Jin Shengjie, Cao Jun, Zhang Chi, Bai Dousheng

机构信息

Department of Hepatobiliary Surgery, Clinical Medical College, Yangzhou University, Yangzhou, China.

Subei People's Hospital Hepatobiliary Surgery, Institute of General Surgery, Yangzhou, China.

出版信息

Surg Innov. 2024 Aug;31(4):362-372. doi: 10.1177/15533506241246335. Epub 2024 Apr 24.

Abstract

BACKGROUND

Accurate recognition of Calot's triangle during cholecystectomy is important in preventing intraoperative and postoperative complications. The use of indocyanine green (ICG) fluorescence imaging has become increasingly prevalent in cholecystectomy procedures. Our study aimed to evaluate the specific effects of ICG-assisted imaging in reducing complications.

MATERIALS AND METHODS

A comprehensive search of databases including PubMed, Web of Science, Europe PMC, and WANFANGH DATA was conducted to identify relevant articles up to July 5, 2023. Review Manager 5.3 software was applied to statistical analysis.

RESULTS

Our meta-analysis of 14 studies involving 3576 patients compared the ICG group (1351 patients) to the control group (2225 patients). The ICG group had a lower incidence of postoperative complications (4.78% vs 7.25%; RR .71; 95%CI: .54-.95; = .02). Bile leakage was significantly reduced in the ICG group (.43% vs 2.02%; RR = .27; 95%CI: .12-.62; I = 0; = .002), and they also had a lower bile duct drainage rate (24.8% vs 31.8% RR = .64, 95% CI: .44-.91, = .01). Intraoperative complexes showed no statistically significant difference between the 2 groups (1.16% vs 9.24%; RR .17; 95%CI .03-1.02), but the incidence of intraoperative bleeding is lower in the ICG group.

CONCLUSION

ICG fluorescence imaging-assisted cholecystectomy was associated with a range of benefits, including a lower incidence of postoperative complications, decreased rates of bile leakage, reduced bile duct drainage, fewer intraoperative complications, and reduced intraoperative bleeding.

摘要

背景

在胆囊切除术中准确识别胆囊三角对于预防术中及术后并发症至关重要。吲哚菁绿(ICG)荧光成像在胆囊切除手术中的应用日益普遍。我们的研究旨在评估ICG辅助成像在减少并发症方面的具体效果。

材料与方法

全面检索了包括PubMed、科学网、欧洲生物医学中心和万方数据在内的数据库,以识别截至2023年7月5日的相关文章。使用Review Manager 5.3软件进行统计分析。

结果

我们对14项研究(涉及3576例患者)的荟萃分析将ICG组(1351例患者)与对照组(2225例患者)进行了比较。ICG组术后并发症发生率较低(4.78%对7.25%;RR = 0.71;95%CI:0.54 - 0.95;P = 0.02)。ICG组胆汁漏显著减少(0.43%对2.02%;RR = 0.27;95%CI:0.12 - 0.62;I² = 0;P = 0.002),并且其胆管引流率也较低(24.8%对31.8%,RR = 0.64,95%CI:0.44 - 0.91,P = 0.01)。两组术中复杂情况无统计学显著差异(1.16%对9.24%;RR = 0.17;95%CI:0.03 - 1.02),但ICG组术中出血发生率较低。

结论

ICG荧光成像辅助胆囊切除术有一系列益处,包括术后并发症发生率较低、胆汁漏发生率降低、胆管引流减少、术中并发症较少以及术中出血减少。

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