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Updated: Sep 16, 2025

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

Advances in intraoperative imaging technologies for complex biliary disease.

Dena G Shehata¹, Carmelle Romain², Bethany J Slater²

¹Department of Surgery, Lahey Hospital and Medical Center, Burlington, MA, USA.

Seminars in Pediatric Surgery

|July 6, 2025

Summary

Intraoperative imaging techniques like fluorescent cholangiography improve pediatric biliary surgery precision. Combining methods enhances decision-making, with future tech promising better outcomes.

Keywords:

Cholangiogram Endoscopic retrograde cholangiopancreatography Indocyanine green Intraoperative imaging Pediatric biliary disease Ultrasound

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Area of Science:

Pediatric Surgery
Medical Imaging
Gastroenterology

Background:

Intraoperative imaging is crucial for enhancing precision and reducing complications in pediatric biliary surgery.
Various imaging modalities are employed, each with unique benefits and drawbacks.

Purpose of the Study:

To review and compare key intraoperative imaging techniques used in pediatric biliary surgery.
To evaluate the advantages and limitations of each modality for improved surgical outcomes.

Main Methods:

Review of intraoperative cholangiography (IOC), fluorescent cholangiography (FC) with indocyanine green (ICG), laparoscopic ultrasound (LUS), and endoscopic retrograde cholangiopancreatography (ERCP).
Analysis of radiation exposure, operative time, visualization capabilities, and procedural risks associated with each technique.

Main Results:

IOC is standard but involves radiation and longer operative times.
FC with ICG offers radiation-free visualization and shorter procedures, contingent on equipment.
LUS provides real-time, radiation-free anatomical assessment but requires expertise.
ERCP has diagnostic/therapeutic roles but carries risks like pancreatitis.

Conclusions:

Each imaging modality offers distinct benefits and limitations in pediatric biliary surgery.
The combined application of these techniques optimizes intraoperative decision-making.
Emerging technologies like AI and AR hold potential for further advancements in surgical outcomes.