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Fluorescent cholangiography in laparoscopic cholecystectomy: the initial Canadian experience
Chris Zroback1, Geoffrey Chow1, Adam Meneghetti1
1Department of Surgery, Division of General Surgery, UBC Faculty of Medicine, 950 West 10th Ave, Vancouver, BC V5Z 1M9, Canada.
Background:
Bile duct injury remains a worrisome complication of laparoscopic cholecystectomy. Indocyanine Green (ICG) fluorescent cholangiography (FC) 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 that FC incorporated smoothly into the operation. No complications have been related to the technology.
Conclusions:
FC allows noninvasive real-time visualization of the extrahepatic 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.
