The role of indocyanine green fluoroscopy for intraoperative bile duct visualization during laparoscopic cholecystectomy: an observational cohort study in 70 ... View Full Text


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Article Info

DATE

2019-12

AUTHORS

Peter C. Ambe, Jens Plambeck, Victoria Fernandez-Jesberg, Konstantinos Zarras

ABSTRACT

Background: Bile duct injury is the most feared complication during laparoscopic cholecystectomy. Real-time intraoperative imaging using indocyanine green (ICG) might reduce the risk of bile duct injury by improving visualization of the biliary tree during laparoscopic cholecystectomy. We compared the outcomes of laparoscopic cholecystectomy in patients with and without real-time ICG. Methods: A retrospective analysis of the data of patients undergoing laparoscopic cholecystectomy with and without ICG in a referral centre for minimally invasive surgery was performed. We hypothesized that laparoscopic cholecystectomy with real-time ICG enables a better identification of the biliary tree and thus increases surgical safety. The outcomes of laparoscopic cholecystectomy with and without ICG were compared using the duration of surgery, the rate of bile duct injury, the rate of conversion, complications and the length of stay. Results: Seventy patients including 29 with and 41 without ICG underwent laparoscopic cholecystectomy within the period of investigation. The median duration of surgery was 53.0 vs. 54.0 min while the median length of stay was 2.0 d in the group with and without ICG respectively. The rate of conversion was 2.4% in the group without ICG, while no conversion was performed in the group with ICG. NO bile duct injury occurred in both groups. These differences were not statistically significant. Conclusion: Laparoscopic cholecystectomy with real-time indocyanine green fluorescence cholangiography enables a better visualization and identification of biliary tree and therefore should be considered as a means of increasing the safety of laparoscopic cholecystectomy. More... »

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2

References to SciGraph publications

  • 2016-12. Surgical management of empyematous cholecystitis: a register study of over 12,000 cases from a regional quality control database in Germany in SURGICAL ENDOSCOPY
  • 2017-04. Outcome of acute perforated cholecystitis: a register study of over 5000 cases from a quality control database in Germany in SURGICAL ENDOSCOPY
  • 2017-02. Mechanism of dynamic near-infrared fluorescence cholangiography of extrahepatic bile ducts and applications in detecting bile duct injuries using indocyanine green in animal models in ACTA ACADEMIAE MEDICINAE WUHAN
  • 2018-03. Near-infrared cholecystocholangiography with direct intragallbladder indocyanine green injection: preliminary clinical results in SURGICAL ENDOSCOPY
  • 2009-02. The routine use of laparoscopic ultrasound decreases bile duct injury: a multicenter study in SURGICAL ENDOSCOPY
  • 2000-02. Einteilung und Behandlung von Gallengangverletzungen nach laparoskopischer Cholecystektomie in DER CHIRURG
  • 2011-07. Is laparoscopic cholecystectomy more challenging in male patients? in SURGICAL ENDOSCOPY
  • 2010-09. Intraoperative exploration of biliary anatomy using fluorescence imaging of indocyanine green in experimental and clinical cholecystectomies in JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES
  • 2015-02. Near-infrared fluorescent cholangiography facilitates identification of biliary anatomy during laparoscopic cholecystectomy in SURGICAL ENDOSCOPY
  • 2006-11. Intraoperative cholangiography lowers the risk of bile duct injury during cholecystectomy in SURGICAL ENDOSCOPY
  • 2013-01. TG13 guidelines for diagnosis and severity grading of acute cholangitis (with videos) in JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES
  • 2017-03. Could ICG-aided robotic cholecystectomy reduce the rate of open conversion reported with laparoscopic approach? A head to head comparison of the largest single institution studies in JOURNAL OF ROBOTIC SURGERY
  • 2014-04. Optimization of near-infrared fluorescence cholangiography for open and laparoscopic surgery in SURGICAL ENDOSCOPY
  • 2013-10. Real-time near-infrared fluorescent cholangiography could shorten operative time during robotic single-site cholecystectomy in SURGICAL ENDOSCOPY
  • 2013-05. Fluorescence cholangiography during laparoscopic cholecystectomy: a feasibility study on early biliary tract delineation in SURGICAL ENDOSCOPY
  • 2016-09. Near-infrared cholecysto-cholangiography with indocyanine green may secure cholecystectomy in difficult clinical situations: proof of the concept in a porcine model in SURGICAL ENDOSCOPY
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1186/s13037-019-0182-8

    DOI

    http://dx.doi.org/10.1186/s13037-019-0182-8

    DIMENSIONS

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    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/30651756


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