ICG Fluorescence Cholangiography During Laparoscopic Cholecystectomy

Abstract

We report our experience for an intraoperative exploration of the biliary anatomy using fluorescence imaging with indocyanine green (ICG) for 25 patients who were planned to perform laparoscopic cholecystectomy. They included ten males and 15 females with a mean age of 57 years and body mass index of 24.5 kg/m². ICG was administered intravenously 1 h before surgery. We observed the biliary tract under a laparoscope with infrared function, and the cystic artery was also observed after reinjection of ICG. There were no additional ports or conversion to open cholecystectomy. The mean operation time was 83 min. We identified the biliary tract with fluorescence imaging in all patients, and the cystic artery was recognized approximately 10 s after reinjection of ICG. There were no specific perioperative complications related to the intravenous injection of ICG. The median postoperative hospital stay was 3 days. Intraoperative exploration of the biliary anatomy using ICG is a useful and safe navigation modality for identification of the biliary anatomy without cannulation manner into the cystic duct, arrangement of X-ray equipment, or use of radioactive materials. This technique will become routine, offering a lower degree of invasiveness that will help to avoid or minimize bile duct and vessel injuries.