Surgical Endoscopy

, Volume 25, Issue 8, pp 2631–2636

Application of fluorescent cholangiography to single-incision laparoscopic cholecystectomy

Authors

  • Takeaki Ishizawa
    • Hepato-Biliary-Pancreatic Surgery Division, Department of SurgeryGraduate School of Medicine, University of Tokyo
    • Department of SurgeryCentral Hospital of Social Health Insurance
  • Junichi Kaneko
    • Hepato-Biliary-Pancreatic Surgery Division, Department of SurgeryGraduate School of Medicine, University of Tokyo
  • Yosuke Inoue
    • Hepato-Biliary-Pancreatic Surgery Division, Department of SurgeryGraduate School of Medicine, University of Tokyo
  • Nobuyuki Takemura
    • Hepato-Biliary-Pancreatic Surgery Division, Department of SurgeryGraduate School of Medicine, University of Tokyo
  • Yasuji Seyama
    • Hepato-Biliary-Pancreatic Surgery Division, Department of SurgeryGraduate School of Medicine, University of Tokyo
  • Taku Aoki
    • Hepato-Biliary-Pancreatic Surgery Division, Department of SurgeryGraduate School of Medicine, University of Tokyo
  • Yoshifumi Beck
    • Hepato-Biliary-Pancreatic Surgery Division, Department of SurgeryGraduate School of Medicine, University of Tokyo
  • Yasuhiko Sugawara
    • Hepato-Biliary-Pancreatic Surgery Division, Department of SurgeryGraduate School of Medicine, University of Tokyo
  • Kiyoshi Hasegawa
    • Hepato-Biliary-Pancreatic Surgery Division, Department of SurgeryGraduate School of Medicine, University of Tokyo
  • Nobuhiro Harada
    • Hepato-Biliary-Pancreatic Surgery Division, Department of SurgeryGraduate School of Medicine, University of Tokyo
    • Department of SurgeryCentral Hospital of Social Health Insurance
  • Masayoshi Ijichi
    • Department of SurgeryCentral Hospital of Social Health Insurance
  • Koji Kusaka
    • Department of SurgeryCentral Hospital of Social Health Insurance
  • Masayuki Shibasaki
    • Department of SurgeryCentral Hospital of Social Health Insurance
  • Yasutsugu Bandai
    • Department of SurgeryCentral Hospital of Social Health Insurance
    • Hepato-Biliary-Pancreatic Surgery Division, Department of SurgeryGraduate School of Medicine, University of Tokyo
Article

DOI: 10.1007/s00464-011-1616-2

Cite this article as:
Ishizawa, T., Kaneko, J., Inoue, Y. et al. Surg Endosc (2011) 25: 2631. doi:10.1007/s00464-011-1616-2

Abstract

Background

Although the use of single-incision laparoscopic cholecystectomy (SILC) is spreading rapidly, this technique has disadvantages. It does not allow for sufficient surgical views to be obtained or for intraoperative radiographic cholangiography to be performed. Fluorescent cholangiography using a preoperative intravenous injection of indocyanine green (ICG) may be useful for identifying the biliary tract during both SILC and conventional laparoscopic cholecystectomy.

Methods

For seven patients undergoing SILC, 1 ml of ICG (2.5 mg) was administered by intravenous injection before the surgery. The prototype fluorescent imaging system consisted of a xenon light source and a 30° laparoscope (diameter, 10 mm) equipped with a charge-coupled device camera capable of filtering out light with wavelengths shorter than 810 nm. The laparoscope was introduced through an umbilical trocar. Fluorescent cholangiography then was performed by changing the color images to fluorescent images using a foot switch during dissection of the triangle of Calot.

Results

Fluorescent cholangiography identified the confluence between the cystic duct and the common hepatic duct in all seven patients before and throughout the dissection of the triangle of Calot. The interval from the injection of ICG to the first obtained fluorescent cholangiography before dissection of the triangle of Calot ranged from 35 to 75 min.

Conclusions

Fluorescent cholangiography enabled real-time identification of the extrahepatic bile ducts during SILC without necessitating catheterization of the bile duct. Such properties of fluorescent cholangiography are expected to be helpful for ensuring the safety of SILC and expanding the indications for the procedure.

Keywords

Fluorescent cholangiographyIndocyanine greenLaparoscopic cholecystectomySingle-incision laparoscopic cholecystectomy

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Copyright information

© Springer Science+Business Media, LLC 2011