Abstract
Background: Laparoscopic cholecystectomy (LC) is a prevalent surgical procedure with inherent risks, notably bile duct injuries (BDIs). Objective: This study aims to evaluate the efficacy of Indocyanine Green (ICG) fluoroscopy in enhancing bile duct identification during LC. Methods: A prospective cohort of 40 patients undergoing LC at Central Hospital Ltd, and Labaid Cancer Hospital and Super Speciality Centre, Dhaka, Bangladesh (2022-2023) was analyzed. Patients received an intravenous dose of ICG (0.5 mg/kg) intraoperatively. Near-infrared fluorescence imaging was employed to visualize biliary structures. Identification rates of bile ducts with and without ICG fluoroscopy were compared using statistical analysis (p < 0.05). Results: ICG fluoroscopy significantly improved bile duct identification, achieving a 95% success rate compared to 72% without ICG (p = 0.003). This represents a 31% relative increase in identification accuracy. The mean operative time was reduced by 15 minutes in the ICG group (mean 92 minutes, SD ±10, range 65-125 minutes). Demographically, 60% were male and 40% female, with a mean age of 37.26 years (SD ±8.5). Additionally, the use of ICG fluoroscopy was associated with a 50% reduction in intraoperative complications related to bile duct misidentification. No adverse events attributable to ICG administration were observed, ensuring its safety profile. The enhanced visualization facilitated clearer delineation of the cystic duct and common bile duct, contributing to improved surgical precision and outcomes. Statistical analysis confirmed the significance of these findings, with confidence intervals for identification rates ranging from 20% to 42%. Conclusions: The integration of ICG fluoroscopy in LC markedly enhances bile duct identification, thereby reducing the incidence of BDIs and improving surgical outcomes. These findings support the routine use of ICG fluoroscopy to enhance patient safety during laparoscopic cholecystectomy
Published Version
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