Usefulness of indocyanine green fluorescence in laparoscopic resection of choledochal cyst in children

Abstract

Image-guided surgery using indocyanine green allows the delineation of anatomical structures during laparoscopic surgery. Dye excretion through the bile duct has also facilitated complicated cholecystectomies. However, there have been few reports of its application in children. To date, its use for minimally invasive treatment of choledochal cyst in children has not been reported. The adequate treatment of this condition requires careful dissection to avoid vascular and visceral lesions as well as biliary digestive reconstruction according to the morphology of the hepatic duct. In the presented case, the application of this technique allowed for the complete dissection of the cyst without vascular injury, the safe ligation of the duodenal segment of the cyst, and a successful duodenal hepatic anastomosis. These were accomplished through laparoscopy by visualizing the passage towards the duodenum and ruling out the presence of fistulas. • The use of indocyanine green has allowed for choledochal cyst excision in this case. • Indocyanine green delineated the dilated common bile duct from the normal structures. • Indocyanine green also confirmed the absence of leaks in the anastomosis.