Near-infrared cholecysto-cholangiography with indocyanine green may secure cholecystectomy in difficult clinical situations: proof of the concept in a porcine model

Abstract

Fluorescence cholecysto-cholangiography through direct intragallbladder ICG injection could rapidly provide an adequate visualization of gallbladder neck and cystic duct and might be a valid option to increase the safety of cholecystectomy in case of cholecystitis.

Indocyanine green-enhanced fluorescence for assessing parathyroid perfusion during thyroidectomy

“…The use of fluorescein and ultraviolet light improves visualization of the biliary topography during laparoscopic cholecystectomy (22)(23)(24)(25)(26). Within 4 to 5 min after application of fluorescein, the bile ducts emit a green fluorescence upon exposure to ultraviolet A light from an LED light source.…”

“…Within 4 to 5 min after application of fluorescein, the bile ducts emit a green fluorescence upon exposure to ultraviolet A light from an LED light source. The fluorescence enables clear differentiation between the biliary system and surrounding tissues (22)(23)(24)(25)(26). The extrahepatic biliary anatomy can be identified faster by fluorescence technique than by conventional white light.…”

“…The extrahepatic biliary anatomy can be identified faster by fluorescence technique than by conventional white light. Tissues remain fluorescent for 42 to 77 min after application of fluorescein, which is a sufficient duration to complete most laparoscopic cholecystectomy procedures (22)(23)(24)(25)(26). Compared to white light, the fluorescence technique allows better and earlier real-time visualization of the biliary anatomy.…”

“…Fluorescence technique provides an additional tool for improving the safety of laparoscopic cholecystectomy. Generally, fluorescence technique can clearly distinguish the biliaryvascular anatomy, and no intraoperative or injection-related adverse effects have been reported (22)(23)(24)(25)(26). The invaluable information provided by this imaging system improves the safety of cholecystectomy and is useful for planning surgery.…”

“…The invaluable information provided by this imaging system improves the safety of cholecystectomy and is useful for planning surgery. Additionally, no case series studies of this procedure have reported bile duct injuries (22)(23)(24)(25)(26).…”