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Clinical value and pitfalls of fluorescent cholangiography during single-incision laparoscopic cholecystectomy

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Abstract

Purpose

To clarify the clinical value and pitfalls of fluorescent cholangiography (FC) during single-incision laparoscopic cholecystectomy (SILC).

Methods

Our SILC procedure utilized the SILS-Port with additional 5-mm forceps through an umbilical incision. A laparoscopic fluorescent imaging system developed by Karl Storz Endoskope was utilized for fluorescent cholangiography.

Results

We performed fluorescent cholangiography during SILC in 21 patients. All procedures were completed successfully without biliary injury. The detectability of the running course of the cystic duct, the confluence between the cystic duct and the common hepatic duct, and the common hepatic duct before the dissection in Calot’s triangle was 47.6, 71.4, and 81.0 %, respectively. The detectability of biliary structures was worse in 9 obese patients (body mass index ≥ 25.0 kg/m2) than in 12 non-obese patients. The mean operative time for the patients in whom fluorescent cholangiography could identify the running course of the cystic duct before dissection in Calot’s triangle (68 ± 16 min) was shorter than that for the other patients (91 ± 35 min; p = 0.037).

Conclusions

Fluorescent cholangiography can prevent biliary injury during SILC and facilitate SILC. Obesity is the most important factor that can prevent identification of biliary structures under fluorescent cholangiography.

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References

  1. Ishizawa T, Bandai Y, Ijichi M, Kaneko J, Hasegawa K, Kokudo N. Fluorescent cholangiography illuminating the biliary tree during laparoscopic cholecystectomy. Br J Surg. 2010;97:1369–77.

    Article  CAS  PubMed  Google Scholar 

  2. Aoki T, Murakami M, Yasuda D, Shimizu Y, Kusano T, Matsuda K, et al. Intraoperative fluorescent imaging using indocyanine green for liver mapping and cholangiography. J Hepatobiliary Pancreat Sci. 2010;17:590–4.

    Article  PubMed  Google Scholar 

  3. Kaneko J, Ishizawa T, Masuda K, Kawaguchi Y, Aoki T, Sakamoto Y, et al. Indocyanine green reinjection technique for use in fluorescent angiography concomitant with cholangiography during laparoscopic cholecystectomy. Surg Laparosc Endosc Percutan. 2012;22:341–4.

    Article  Google Scholar 

  4. Schols RM, Bouvy ND, Masclee AA, van Dam RM, Dejong CH, Stassen LP. Fluorescence cholangiography during laparoscopic cholecystectomy: a feasibility study on eraly biliary tract delineation. Surg Endosc. 2013;27:1530–6.

    Article  PubMed  Google Scholar 

  5. Osayi SN, Wnfdling MR, Drosdeck JM, Chaudhry UI, Perry KA, Noria SF, et al. Near-infrared fluorescent cholangiography facilitates identification of biliary anatomy during laparoscopic cholecystectomy. Surg Endosc. 2015;29:368–75.

    Article  PubMed  Google Scholar 

  6. Ishizawa T, Kaneko J, Inoue Y, Takemura N, Seyama Y, Aoki T, et al. Application of fluorescent cholangiography to single-incision laparoscopic cholecystectomy. Surg Endosc. 2011;25:2631–6.

    Article  PubMed  Google Scholar 

  7. Igami T, Usui H, Ebata T, Yokoyama Y, Sugawara G, Takahashi Y, et al. Single-incision laparoscopic cholecystectomy for porcelain gallbladder: a case report. Asian J Endosc Surg. 2013;6:52–4.

    Article  PubMed  Google Scholar 

  8. Igami T, Aoba T, Ebata T, Yokoyama Y, Sugawara G, Nagino M. Single-incision laparoscopic cholecystectomy for cholecystitis requiring percutaneous transhepatic gallbladder drainage. Surg Today. 2015;45:305–9.

    Article  PubMed  Google Scholar 

  9. Japan Society for the Study of Obesity issued. Criteria for obesity disease 2011. Obesity Research vol. 17 Extra Edition 2011.

  10. Strasberg SM, Hertl M, Soper NJ. An analysis of the problem of biliary injury during laparoscopic cholecystectomy. J Am Coll Surg. 1995;180:101–25.

    CAS  PubMed  Google Scholar 

  11. Ueno D, Nakashima H, Higashida M, Yoshida K, Hino K, Irei I, et al. Emergent laparoscopic cholecystectomy for acute acalculous cholecystitis revisited. Surg Today. 2016;46:309–12.

    Article  PubMed  Google Scholar 

  12. Partelli S, Barugola G, Sartoti A, Crippa S, Falconi M, Ruffo G. Single-incision laparoscopic cholecystectomy versus traditional laparoscopic cholecystectomy performed by a single surgeon: findings of a randomized trial. Surg Today. 2016;46:313–8.

    Article  PubMed  Google Scholar 

Download references

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Authors and Affiliations

  1. Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan

    Tsuyoshi Igami, Motoi Nojiri, Kentaro Shinohara, Tomoki Ebata, Yukihiro Yokoyama, Gen Sugawara, Takashi Mizuno, Junpei Yamaguchi & Masato Nagino

Authors
  1. Tsuyoshi Igami
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  2. Motoi Nojiri
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  3. Kentaro Shinohara
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  4. Tomoki Ebata
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  5. Yukihiro Yokoyama
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  6. Gen Sugawara
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  7. Takashi Mizuno
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  8. Junpei Yamaguchi
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  9. Masato Nagino
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Corresponding author

Correspondence to Tsuyoshi Igami.

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Igami, T., Nojiri, M., Shinohara, K. et al. Clinical value and pitfalls of fluorescent cholangiography during single-incision laparoscopic cholecystectomy. Surg Today 46, 1443–1450 (2016). https://doi.org/10.1007/s00595-016-1330-8

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  • DOI: https://doi.org/10.1007/s00595-016-1330-8

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