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Updated: Sep 3, 2025

The Role of Indocyanine Green Fluorescence in Complex Laparoscopic Cholecystectomy Navigation
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Multimodality Imaging of Cholecystectomy Complications.

Neel Patel1, Kyle K Jensen1, Akram M Shaaban1

  • 1From the Department of Diagnostic Radiology, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239 (N.P., K.K.J., E.K., B.R.F.); and Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah (A.M.S.).

Radiographics : a Review Publication of the Radiological Society of North America, Inc
|July 29, 2022
PubMed
Summary

Radiologists frequently encounter cholecystectomy complications, which can manifest weeks or years post-surgery. Multimodality imaging is crucial for diagnosing these diverse biliary, stone-related, iatrogenic, and gallbladder issues.

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Area of Science:

  • Radiology
  • Gastroenterology
  • Surgical Oncology

Background:

  • Cholecystectomy is a highly prevalent surgical procedure in the United States.
  • Postoperative complications, though uncommon, are frequently encountered by radiologists due to the surgery's high incidence.
  • Clinical diagnosis of complications can be challenging due to vague and nonspecific symptoms.

Purpose of the Study:

  • To provide a comprehensive overview of cholecystectomy complications.
  • To categorize complications into four main groups: biliary, stone-related, iatrogenic, and gallbladder-related.
  • To emphasize the importance of multimodality imaging in the postoperative evaluation.

Main Methods:

  • Discussion of surgical techniques and expected postoperative findings.
  • Systematic description of complications categorized into four groups.
  • Review of imaging modalities including ultrasound, CT, hepatobiliary scintigraphy, SPECT/CT, and MRI.

Main Results:

  • Complications are classified into biliary (bile leaks, bilomas, obstruction, stricture), stone-related (retained/recurrent stones, spillage), iatrogenic (hemorrhage, vascular injury, pseudoaneurysms, duodenal injury, clip migration), and gallbladder-related (recurrent cholecystitis, unexpected cancer).
  • Immediate and delayed complications can occur, presenting diagnostic challenges.
  • Multimodality imaging is essential for accurate diagnosis.

Conclusions:

  • A structured approach to imaging is vital for diagnosing a wide spectrum of cholecystectomy complications.
  • Understanding surgical techniques and potential complications aids in accurate interpretation.
  • Advanced imaging techniques play a complementary role in the comprehensive workup of postoperative patients.