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Updated: May 7, 2026

The Role of Indocyanine Green Fluorescence in Complex Laparoscopic Cholecystectomy Navigation

The Role of Indocyanine Green Fluorescence in Complex Laparoscopic Cholecystectomy Navigation

Published on: January 31, 2025

Hyperkinetic gallbladder: an indication for cholecystectomy?

Erika B Lindholm¹, J Brannon Alberty, Faith Hansbourgh

¹Department of Surgery, Louisiana State University, New Orleans, Louisiana, USA.

The American Surgeon

|September 28, 2013

Summary

Cholecystectomy can relieve biliary colic in children with normal ultrasounds and high gallbladder ejection fractions on CCK-HIDA scans. This gallbladder removal surgery offers symptom relief for pediatric patients with specific gallbladder dysfunction.

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Last Updated: May 7, 2026

The Role of Indocyanine Green Fluorescence in Complex Laparoscopic Cholecystectomy Navigation

The Role of Indocyanine Green Fluorescence in Complex Laparoscopic Cholecystectomy Navigation

Published on: January 31, 2025

Area of Science:

Pediatric Surgery
Gastroenterology
Diagnostic Imaging

Background:

Biliary colic in children often presents without gallstones.
Abnormal gallbladder function, indicated by low or high ejection fraction on cholecystokinin-hepatobiliary iminodiacetic acid (CCK-HIDA) scans, is implicated.

Purpose of the Study:

To evaluate the efficacy of cholecystectomy in pediatric patients with symptomatic biliary colic and abnormal CCK-HIDA scan findings, specifically high ejection fractions.
To assess symptom relief and outcomes following gallbladder removal in this specific pediatric population.

Main Methods:

Retrospective review of pediatric patients (<18 years) who underwent cholecystectomy between 2008-2012.
Inclusion criteria: negative ultrasound (US) and CCK-HIDA ejection fraction ≥80%.
Data collection included chart review and postoperative symptom assessment via phone interviews.

Main Results:

12 out of 174 (7%) patients met the study criteria.
All 12 patients had confirmed cholecystitis on pathology.
11 of 12 patients reported complete relief of biliary colic symptoms post-surgery, with a mean follow-up of 16 months.

Conclusions:

Cholecystectomy can be a beneficial treatment for select pediatric patients experiencing biliary colic with normal ultrasounds and high ejection fractions on CCK-HIDA scans.
High gallbladder ejection fraction in symptomatic children may indicate a functional gallbladder disorder treatable with cholecystectomy.