Abstract
BackgroundBile duct injury is the most feared complication during laparoscopic cholecystectomy. Real-time intraoperative imaging using indocyanine green (ICG) might reduce the risk of bile duct injury by improving visualization of the biliary tree during laparoscopic cholecystectomy. We compared the outcomes of laparoscopic cholecystectomy in patients with and without real-time ICG.MethodsA retrospective analysis of the data of patients undergoing laparoscopic cholecystectomy with and without ICG in a referral centre for minimally invasive surgery was performed. We hypothesized that laparoscopic cholecystectomy with real-time ICG enables a better identification of the biliary tree and thus increases surgical safety. The outcomes of laparoscopic cholecystectomy with and without ICG were compared using the duration of surgery, the rate of bile duct injury, the rate of conversion, complications and the length of stay.ResultsSeventy patients including 29 with and 41 without ICG underwent laparoscopic cholecystectomy within the period of investigation. The median duration of surgery was 53.0 vs. 54.0 min while the median length of stay was 2.0 d in the group with and without ICG respectively. The rate of conversion was 2.4% in the group without ICG, while no conversion was performed in the group with ICG. NO bile duct injury occurred in both groups. These differences were not statistically significant.ConclusionLaparoscopic cholecystectomy with real-time indocyanine green fluorescence cholangiography enables a better visualization and identification of biliary tree and therefore should be considered as a means of increasing the safety of laparoscopic cholecystectomy.
Highlights
Cholecystectomy is one of the most commonly performed procedures in general surgery with over a million procedures worldwide each year [1]
Seventy patients undergoing laparoscopic cholecystectomy for benign gallbladder disorders managed by a single surgeon within the period of investigation from December 2015 to December 2017 were included for analysis
The study group included 29 cases of laparoscopic cholecystectomy with indocyanine green (ICG) while the control group consisted of 41 consecutive cases of laparoscopic cholecystectomy without ICG performed by the same surgeon prior to introduction of ICG
Summary
Cholecystectomy is one of the most commonly performed procedures in general surgery with over a million procedures worldwide each year [1]. Bile duct injury with varying severity (2019) 13:2 laparoscopic cholecystectomy might have devastating consequences for the patients involved [6, 7]. Many measures have been implemented to reduce the risk of bile duct injury during laparoscopic cholecystectomy. Intraoperative sonographic and radiographic examination of the biliary tree constitute standard methods for studying the biliary anatomy during surgery [9, 10]. Despite these measures, bile duct injury still remains a serious problem. Real-time intraoperative imaging using indocyanine green (ICG) might reduce the risk of bile duct injury by improving visualization of the biliary tree during laparoscopic cholecystectomy. We compared the outcomes of laparoscopic cholecystectomy in patients with and without real-time ICG
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
