Real-time Fluorescence Imaging of Biliary Anatomy During Laparoscopic Cholecystectomy

Background: We evaluate real-time fluorescence imaging of biliary anatomy using indocyanine green (ICG) during laparoscopic cholecystectomy.

Patients and Methods: This study enrolled eight patients who underwent laparoscopic cholecystectomy. ICG was injected 2 hours before exploration. Under general anesthesia, we observed biliary tract under the guidance of real-time fluorescence imaging produced by prototype laparoscope. The flow of the cystic artery after re-injection of ICG was also observed by the same laparoscope.

Results: We obtained the clear vision of biliary tract in all patients. The local compression of transparent and hemispheric plastic cap after re-injection of ICG provided with a further clear anatomy of biliary tract. The cystic artery was also identified in 6 of 8 patients. There were no particular perioperative complications related with an intravenous injection of ICG.

Conclusion: The advantages of this method are no cannulation manner into cystic duct, no arrangement of X-ray equipment and no radio-activity. However, we have to consider the adequate timing of ICG injection and obtain the similar visualization of biliary tract compared with standard intraoperative cholangiography.

Session: Podium Presentation

Program Number: S016

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