• Skip to primary navigation
  • Skip to main content
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Advocacy
    • Strategic Plan, 2020-2023
    • Committees
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • SAGES Store
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Social Justice and Health Equity
      • Excellence in Community Surgery
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
    • “Unofficial” Logo Products
  • Meetings
    • NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2024 Scientific Session Call For Abstracts
      • 2024 Emerging Technology Call For Abstracts
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Related Meetings Calendar
  • Join SAGES!
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • SAGES Stories Podcast
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • COVID-19 Annoucements
    • Troubleshooting Guides
  • Education
    • Wellness Resources – You Are Not Alone
    • OpiVoid.org
    • SAGES.TV Video Library
    • Safe Cholecystectomy Program
      • Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Fellows Career Development Course
    • Robotics Fellows Course
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES OR SAFETY Video
    • SAGES Top 21 MIS Procedures
    • SAGES Pearls
    • SAGES Flexible Endoscopy 101
    • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • NEW-Area of Concentrated Training Seal (ACT)-Advanced Flexible Endoscopy
    • SAGES Fellowship Certification for Advanced GI MIS and Comprehensive Flexible Endoscopy
    • Multi-Society Foregut Fellowship Certification
    • SAGES Research Opportunities
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • OWLS
  • Log In

Near-infrared fluorescent cholangiography does not facilitate the identification of biliary anatomy in acute cholecystitis during laparoscopic cholecystectomy.

Jennifer Schwartz, MD1, Sylvester Osayi, MD1, Michael P Meara, MD1, Peter Muscarella, MD1, Kyle A Perry, MD1, Umer I Chaudhry, MD2, Daniel A Eiferman, MD1, W. Scott Melvin, MD3, Jeffrey W Hazey1, Vimal K Narula, MD1. 1The Ohio State University Wexner Medical Center, 2Kaiser Permanente, San Diego, CA, 3Montefiore Medical Center

Background: Intraoperative cholangiography (IOC) is the gold standard for identification of biliary anatomy during laparoscopic cholecystectomy. A previous study performed by Osayi et al demonstrated the Near-infrared fluorescence cholangiography (NIRF-C), which allows for imaging of biliary anatomy in real-time, was an effective alternative to IOC for patients with symptomatic biliary disease who underwent elective laparoscopic cholecystectomy. This study is to assess the efficacy of NIRF-C for identification of biliary anatomy in the acute cholecystitis.

Methods: Patients were administered indocyanine green (ICG) prior to surgery. NIRF-C was used identify extrahepatic biliary structures before and after dissection of Calot’s triangle. Routine intraoperative cholangiogram (IOC) was performed in each case. Identification of biliary structures and NIRF-C was evaluated.

Results: 6 patients underwent laparoscopic cholecystectomy for acute cholecystitis with NIRF-C and IOC. Mean age and BMI were 50 years and 31.14 kg/m² respectively. IOC was only able to be completed in 3/6 (50%) of patients, with 2/3 (66%) patients with complete biliary anatomy visualization. In the patients where IOC was able to be performed, NIRF-C was significantly faster than IOC (1.08 vs 17.87 minutes). NIRF-C did not visualize the biliary structures in 6/6 (100%) of patients prior to dissection of the anatomy. Complete biliary anatomy visualization, including right and left hepatic ducts, common hepatic, cystic duct, and common bile duct, failed in all 6 patients (100%). After final dissection, the common hepatic duct and common bile duct were visualized in 2 patients and the cyst duct visualized in 3 patients. Visualization did not always correlate with ability to perform cholangiogram, as 1 patient had partial biliary visualization with NIRF-C despite inability to perform IOC. No adverse events were observed with NIRF-C.

Conclusions: Acute cholecystitis can make visualization of the biliary system quite difficult and a method for identification of structures in this setting is of particular interest. While NIRF-C was promising for identification of biliary anatomy in the elective setting for non-acute gallbladder pathology, it does not appear to assist with identification of complete biliary anatomy with acute inflammation. IOC still remains the gold standard in this subset of patients.

65

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

Hours & Info

11300 West Olympic Blvd, Suite 600
Los Angeles, CA 90064
1-310-437-0544
[email protected]
Monday - Friday
8am to 5pm Pacific Time

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Important Links

SAGES 2024 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

Copyright © 2023 Society of American Gastrointestinal and Endoscopic Surgeons