Indocyanine Green as an Alternative to Intraoperative Cholangiogram to Delineate Extrahepatic Biliary Tract in Laparoscopic Cholecystectomy
Bibliographic Information
Authors: Nouh M.A.; Helmy A.S.; Abbas M.; Nasr M.; Esmat M.E.; Aziz S.A.; Elmeligy H.A.
Journal: Surgery, Gastroenterology and Oncology
Publisher: Editura Celsius
Publication Date: 2024
Volume / Issue: Volume 29 / Issue 3
Pages: 219–227
ISSN: 2559723X
DOI: 10.21614/sgo-698
Scopus: View on Scopus
Document Type: Article
Access: All Open Access; Gold Open Access
Authors and Affiliations
Nouh M.A., Department of General Surgery, Theodor Bilharz Research Institute, Giza, Egypt; Helmy A.S., Department of General Surgery, Faculty of Medicine, Cairo University, Egypt; Abbas M., Department of General Surgery, Theodor Bilharz Research Institute, Giza, Egypt; Nasr M., Department of General Surgery, Theodor Bilharz Research Institute, Giza, Egypt; Esmat M.E., Department of General Surgery, Theodor Bilharz Research Institute, Giza, Egypt; Aziz S.A., Department of General Surgery, Faculty of Medicine, Cairo University, Egypt; Elmeligy H.A., Department of General Surgery, Theodor Bilharz Research Institute, Giza, Egypt
Abstract
Background: Laparoscopic cholecystectomy (LC) is a common operation in abdominal surgery. Injury to bile duct during LC is still relatively high. The emerging fluorescence-based intraoperative near-infrared cholangiography by Indocyanine green (ICG) and intraoperative cholangiogram (IOC) are mainly two intraoperative imaging techniques to delineate extrahepatic biliary tree during LC. Material and Methods: This prospective non randomized clinical study included 50 consecutive patients underwent elective laparoscopic cholecystectomy with no history of acute attack nor obstructive jaundice. All patients had been subjected to two different cholangiography techniques in the same patient. First, preoperative intravenous injection of ICG, and secondly, conventional intraoperative cholangiogram for more delineation of extrahepatic biliary tree. All cholecystectomies were performed in Theodor Bilharz Research Institute (TBRI) hospital during the period from November 2021 to August 2022. Patients were analyzed pre-operative, intra-operative & post-operative. Results: Females represented almost the included participants (80%), mean age was 40.5 and mean BMI was 31.92. The mean total operative time was 82.5 min. & mean IOC time was 26.14 min. Visualization of CD, CHJ, CBD and CHD were more obvious by using ICG intravenously than conventional visual inspection before dissection of Calot’s triangle with significant statistical difference (P value < 0.001). After dissection of Calot’s triangle, there is no statistical difference between using ICG and conventional IOC in visualization of extrahepatic biliary. No adverse reactions were recorded. No Complications were detected. Conclusion: Our results suggest that IOC using ICG is a feasible, safe, fast and more effective technique than conventional IOC for biliary tract identification before and after dissection of Calot’s triangle and may constitute a powerful diagnostic test for delineation of extrahepatic biliary tract in laparoscopic cholecystectomy. Copyright © Celsius Publishing House.
Keywords
indocyanine green; intraoperative cholangiography; laparoscopic cholecystectomy; near infrared fluorescence
Citation Information
Scopus Citations: 0
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