Fluorescent Cholangiography in Laparoscopic Cholecystectomy: The Initial Canadian Experience

• Published in: The American journal of surgery Vol. 211; no. 5; pp. 933 - 937
• Main Authors: Zroback, Chris, MD, Chow, Geoffrey, MD, Meneghetti, Adam, MD MHSC FRCSC, Warnock, Garth, MD FRCSC, Meloche, Mark, MD FRCSC, Chiu, Chieh Jack, MD FRCSC, Panton, Ormond Neely, MB BS FRCSC FACS
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.05.2016; Elsevier Limited
• Subjects: Adult; Aged; Bile; Bile Ducts; Body mass index; British Columbia; Canada; Cholangiography; Cholangiography - methods; Cholecystectomy; Cholecystectomy, Laparoscopic - adverse effects; Cholecystectomy, Laparoscopic - methods; Cohort Studies; Dissection; Elective Surgical Procedures - methods; Endoscopy; Female; Fluorescence; Follow-Up Studies; Gallbladder; Gallbladder diseases; Humans; Indocyanine Green; Intraoperative Care - methods; Intraoperative Complications; Intraoperative Complications - diagnosis; Laparoscopic Cholecystectomy; Laparoscopy; Male; Medical imaging; Medical personnel; Middle Aged; Patient Safety; Postoperative Complications - epidemiology; Postoperative Complications - physiopathology; Quality Improvement; Retrospective Studies; Risk Assessment; Surgery; Treatment Outcome; Visualization; Intraoperative Complications; Cholangiography; Bile Ducts; Quality Improvement; Laparoscopic Cholecystectomy; Indocyanine Green
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2016.01.013

Abstract Background Bile duct injury remains a worrisome complication of laparoscopic cholecystectomy. Indocyanine Green (ICG) fluorescent cholangiography is a new approach that facilitates real-time intraoperative identification of biliary anatomy. This technology is hoped to improve the safety of dissection within Calot’s triangle. Method Demographics, intraoperative details and subjective surgeon data were recorded for elective cholecystectomy cases involving ICG. Goals were to identify rates of bile duct identification, and assess the perceived benefit of the device. Results ICG was used in 12 biliary cases in Canada. Visualization rates of the cystic and common bile ducts were 100% and 83% respectively. Also, 83% of surgeons felt fluorescent cholangiography incorporated smoothly into the operation. No complications have been related to the technology. Conclusions Fluorescent cholangiography allows non-invasive real time visualization of the extra-hepatic biliary tree. This novel technique has received positive feedback in its initial Canadian use and will likely be a durable adjunct for minimally invasive surgery.