Effectiveness of Intraoperative Cholangiography Using Indocyanine Green (Versus Contrast Fluid) for the Correct Assessment of Extrahepatic Bile Ducts During Day-Case ... View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2014-06-11

AUTHORS

F. Prevot, L. Rebibo, C. Cosse, F. Browet, C. Sabbagh, J.-M. Regimbeau

ABSTRACT

IntroductionDuring cholecystectomy, intraoperative cholangiography using contrast fluid (IOC-CF) is still the “gold standard” for biliary tract identification but has many associated pitfalls. A new IOC technique using indocyanine green (IOC-IG) appears to be promising. Here, we studied the effectiveness of IOC-IG (vs IOC-CF) during day-case laparoscopic cholecystectomy.Materials and MethodsOver a 6-month period, we included 23 patients (with no cirrhosis or risk factors for choledocholithiasis) scheduled for day-case laparoscopic cholecystectomy. The primary efficacy criterion was the “analyzability rate” (i.e., the ability to identify the cystic duct, the cystic duct-hepatic duct junction, and the common bile duct) for the IOC-CF and IOC-IG procedures after dissection. Indocyanine green was infused under general anesthesia. The same near-infrared laparoscopic imaging system was used for IOC-IG and conventional visual inspection. IOC-CF was always attempted after dissection. Each patient served as his/her own control. Cholecystectomies were video-recorded for subsequent off-line, blind analysis.ResultsThe analyzability rate was 74 % for IOC-IG after dissection, 70 % for IOC-CF (p = 0.03), 26 % for conventional visual inspection, and 48 % for IOC-IG before dissection. When each IOC modality (conventional visual inspection, IOC-IG before and after dissection) was considered as a diagnostic test, the accuracy for simultaneous identification of the three anatomic elements was respectively 48, 52, and 74 %. No adverse events occurred during the IOC-IG procedure.ConclusionIOC-IG was feasible and safe. Our results suggest that this technique is more effective than IOC-CF for biliary tract identification after dissection and may constitute a powerful diagnostic test for the detection of extrahepatic ducts. More... »

PAGES

1462-1468

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s11605-014-2560-y

DOI

http://dx.doi.org/10.1007/s11605-014-2560-y

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1053655827

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/24916587


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