Green light for safer biliary surgery: The expanding role of fluorescent cholangiography

Near-infrared fluorescent cholangiography (NIFC) has emerged as a promising technique in laparoscopic cholecystectomy (LC), enabling accurate anatomical identification of the biliary tract. Its use has been associated with improved visualisation of critical structures, reduced incidence of complications, lower conversion rates to open surgery, and shorter operative times and hospital stays. Key advantages include its easy integration into routine practice, a short learning curve, and straightforward interpretation of images, provided that appropriate protocols are followed. Nevertheless, several limitations currently hinder its widespread standardization. The absence of high-quality evidence prevents consensus on the optimal indocyanine green dose and timing of administration, while the need for specialized imaging systems restricts universal adoption. Future research should focus on defining uniform protocols, validating their impact on LC outcomes, and consolidating the role of NIFC as an intraoperative reference technique for enhancing safety and efficiency in biliary surgery.