Efficacy of near-infrared fluorescence cholangiography using indocyanine green in laparoscopic cholecystectomy: A retrospective study

Abstract

Context: While laparoscopy has been the standard procedure for gallstone treatment, recent advances including the use of indocyanine green (ICG) in laparoscopic cholecystectomy have made it easier to understand the biliary tree and reduce the risk of bile duct injury. Aims: In this retrospective study, we aim to determine the efficacy of ICG in near-infrared fluorescence cholangiography (NIRFC) for visualising biliary anatomy. Settings and Design: A total of 90 patients with the symptoms of cholelithiasis were enrolled for this retrospective study. Subjects and Methods: All the patients underwent cholecystectomy approximately 53.8 min (40–90 min) after the intravenous administration of mean volume 1.6 ml (1–2 ml) ICG. The surgeons used NIRFC along with ICG for real-time visualisation of biliary anatomy. Results: The mean operative time for the surgery was 65.7 min (25-120 min) with no post-surgical complications observed in the patients. The average length of stay was 2 days (1–3 days). ICG usage with NIRFC enabled identification of cystic duct, common hepatic and common bile duct, the junction between common hepatic and bile duct, right and left hepatic duct in 87.7%, 94.4%, 80% and 14.4% of cases, respectively. Conclusions: ICG fluorescence allowed successful visualisation of at least 1 biliary structure in 100% of cases.

Keywords

• biliary anatomy
• cholecystectomy
• indocyanine green
• infrared fluorescence