Abstract: Objective To investigate the optimal intravenous dosage of indocyanine green （ICG） during laparoscopic cholecystectomy （LC）. Methods Eighty patients scheduled for fluorescence-guided laparoscopic cholecystectomy （LC） in the Department of General Surgery, Puning People's Hospital, from January 2024 to December 2024 were enrolled as research subjects. They were randomly divided into four groups with 20 cases each using the envelope method. Different doses of indocyanine green （ICG） were intravenously injected intraoperatively in each group： 0.125 mg, 0.25 mg, 0.5 mg, and 5 mg. The extrahepatic bile duct visualization time, visualization rate, and fluorescence intensity of the liver and bile duct were observed in the four groups. Additionally, the fluorescence intensity ratio between the two （bile duct-to-liver ratio, BLR） was analyzed to evaluate the effect of cholangiography. Results The 0.5 mg group exhibited a superior visualization rate, with a statistically significant difference among the four groups （P=0.01）. There was no statistically significant difference in the common bile duct visualization time across the four groups （P=0.162）. For the stratified analysis of the bile duct-to-liver ratio （BLR）, we counted the number of eligible cases with BLR≥1, BLR≥1.5, BLR≥2, and BLR≥2.5, respectively. The results showed that under the above four BLR stratification criteria, the number of eligible cases in the 0.5 mg group was the highest among the four groups, and there were statistically significant overall differences among the four groups （all P<0.05）. Conclusion Intravenous injection of 0.5 mg ICG during LC provides optimal fluorescence imaging for the extrahepatic biliary tract.

Key words: acute cholecystitis, fluorescence cholangiography, indocyanine green, laparoscopic cholecystectomy

摘要： 目的 探讨LC术中经静脉注射吲哚菁绿（ICG）的最佳剂量。方法 选取2024年1月至2024年12月在普宁市人民医院普外科拟行荧光导航LC的80例患者作为研究对象,采用分配隐藏的随机信封法分为四组,每组20例。各组术中分别静脉注射不同剂量ICG：0.125 mg、0.25 mg、0.5 mg和5 mg。观察四组患者的肝外胆管显影时间、显影率及肝脏和胆管的荧光强度,并计算胆管与肝脏的荧光强度比值（胆管肝脏比,BLR）,以评估胆管造影效果。结果 0.5 mg组表现出更好的显影率,四组患者显影率差异有统计学意义（P=0.01）;四组患者胆总管显影时间差异无统计学意义（P=0.162）。在BLR≥1、BLR≥1.5、BLR≥2及BLR≥2.5四个BLR分层标准下,0.5 mg组的合格病例数均为四组中最高,四组间整体差异均有统计学意义（均P<0.05）。结论 LC术中静脉注射0.5 mg ICG,对肝外胆道荧光显影效果更佳。

关键词: 急性胆囊炎, 荧光胆道造影, 吲哚菁绿, 腹腔镜胆囊切除术