Abstract: Objective   To evaluate the application value of SpyGlass system in laparoscopic cholecystectomy for difficult gallbladder.  Methods   Seventy-six patients underwent laparoscopic cholecystectomy for difficult gallbladder in our hospital from April 2019 to April 2022 were enrolled,and patients were classified into two groups by random number table methods,each with 38 cases.Control group received routine laparoscopic cholecystectomy,while experimental group received laparoscopic cholecystectomy under SpyGlass system guidance.Then the operation indexes (operation time,intraoperative blood loss,rate of conversion to open surgery),and clinical indicators (postoperative fasting time,first postoperative exhaust time,out-of-bed activity time) were compared between two groups,meantime,the postoperative recovery and complication rate were also recorded in both groups.   Results  Experimental group had shorter operation time and less intraoperative blood loss than those of control group,with statistical difference (P<0.05).The rate of conversion to open surgery was 2.63% (1/38) in experimental group,which was lower than 15.78% (6/38) in control group,with statistical difference (P<0.05).Experimental group had decreased time to postoperative fasting,first postoperative exhaust and out-of-bed activity than control group,with statistical difference (P<0.05).The C-reactive protein (CRP) and white blood cell count (WBC) levels at postoperative 1 day yielded no statistical difference between two groups (P>0.05).The complication rate was 5.26% in experimental group,which was lower than15.78% in control group,with statistical difference (P<0.05).  Conclusion   Application of SpyGlass system in laparoscopic cholecystectomy for difficult gallbladder is effective and safe,which can effectively shorten the operation time,reduce the intraoperative blood loss,and decrease the rate of conversion to open surgery with good postoperative recovery in patients.

Key words: SpyGlass system, laparoscopic cholecystectomy, laparoscope