The critical view of safety: Enhanced imaging with use of near infrared fluorescent cholangiography

C J Polistena, H Ali, W S Melvin. Montefiore Medical Center

As acknowledged by the SAGES Safe Cholecystectomy Program, biliary injuries are unacceptable, and focus on reducing incidence is essential. Injury may be avoided with appropriate identification of the extrahepatic biliary structures and use of the critical view of safety. While liberal utilization of intraoperative cholangiography has been recommended for visualization of biliary anatomy, the literature reports infrequent use of this method for various reasons. Near infrared fluorescent cholangiography is a safe and cost effective alternative for visualization of the biliary anatomy. The practicality and accessibility of this new technology make it a promising tool for use during laparoscopic cholecystectomy. 

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