Application of Intraoperative Fluorescence Imaging with Indocyanine Green in the Difficult Gallbladder: A Comparative Study between Indocyanine Green–Guided Fluorescence Cholangiography and Conventional Surgery

Hai, Huang; Du, Danwei; Wang, Ziqiang; Xie, Yangyang; Ni, Zhongkai; Li, Xiaowen; Jin, Haimin

doi:10.1089/lap.2022.0467

Cited by 9 publications

(6 citation statements)

References 34 publications

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“…ICG is a near-infrared fluorescent dye that can be rapidly taken up by liver cells and excreted in a free form through the biliary system into the intestine, and then excreted in feces without intermediate metabolites. [23] When ICG is combined with the protein in bile juice, it emits infrared light with a wavelength of about 840 nm, which can be captured by an infrared camera to show the condition of the liver and biliary duct. Due to this characteristic, ICG is increasingly applied in clinical studies, especially in those involving hepatobiliary surgery and oncology surgery.…”

Section: Discussionmentioning

confidence: 99%

Role of indocyanine green-guided near-infrared fluorescence imaging in identification of the cause of neonatal cholestasis

Zhang,

He,

et al. 2024

Medicine

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To evaluate the efficacy and safety of indocyanine green (ICG)-guided near-infrared fluorescence (NIRF) imaging during surgery to diagnose the cause of neonatal cholestasis (NC). Data on NC patients who underwent both NIRF with ICG and conventional laparoscopic bile duct exploration (the gold standard) at our institute from January 2022 to December 2022 were retrospectively analyzed. The patients’ baseline characteristics and liver function outcomes were collected and analyzed, and the diagnostic consistency was compared between the 2 methods. In total, 16 NC patients were included in the study, comprising 8 (50%) male and 8 (50%) female patients, ranging in age from 42 to 93 days, with a median age of 54.4 ± 21 days. During surgery, all the patients underwent NIRF with ICG, followed by conventional laparoscopic bile duct exploration. Finally, 15 of the patients were diagnosed with biliary atresia (BA) (1 with type-I BA, and 14 with type-II BA). The other patient was diagnosed with cholestasis. The diagnostic results from fluorescence imaging with ICG were consistent with those from conventional laparoscopic bile duct exploration. ICG-guided NIRF is associated with an easy operation, less trauma, and good safety. Also, its diagnostic accuracy is similar to conventional laparoscopic bile duct exploration.

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Section: Discussionmentioning

confidence: 99%

Role of indocyanine green-guided near-infrared fluorescence imaging in identification of the cause of neonatal cholestasis

Zhang,

He,

et al. 2024

Medicine

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“…A total of 1148 studies were initially identified, and after careful evaluation, 14 studies 13,[15][16][17][18][19][20][21][22][23][24][25][26][27] were included in this meta-analysis. The selection procedures followed the PRISMA flowchart (Figure 1).…”

Section: Study Selection and Characteristicsmentioning

confidence: 99%

“…The primary objective of this study was to assess the effect of fluorescein ICG assistance on the occurrence of postoperative complications following cholecystectomy. Ultimately, our meta-analysis incorporated a total of 12 studies, [13][14][15][16][17][18][19][20][21][22][23][24] encompassing 3024 patients, to investigate this specific outcome. Among the patients, the incidence of total postoperative complications in the ICG group was 4.78%, compared to 7.25% in the control group (RR .71; 95%CI: .54-.95) (Figure 3A).…”

Section: Study Selection and Characteristicsmentioning

confidence: 99%

Effects of Indocyanine Green (ICG) Imaging-Assisted Cholecystectomy on Intraoperative and Postoperative Complications: A meta-Analysis

Tang,

Liu,

Liu

et al. 2024

Surg Innov

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Background Accurate recognition of Calot’s triangle during cholecystectomy is important in preventing intraoperative and postoperative complications. The use of indocyanine green (ICG) fluorescence imaging has become increasingly prevalent in cholecystectomy procedures. Our study aimed to evaluate the specific effects of ICG-assisted imaging in reducing complications. Materials and Methods A comprehensive search of databases including PubMed, Web of Science, Europe PMC, and WANFANGH DATA was conducted to identify relevant articles up to July 5, 2023. Review Manager 5.3 software was applied to statistical analysis. Results Our meta-analysis of 14 studies involving 3576 patients compared the ICG group (1351 patients) to the control group (2225 patients). The ICG group had a lower incidence of postoperative complications (4.78% vs 7.25%; RR .71; 95%CI: .54-.95; P = .02). Bile leakage was significantly reduced in the ICG group (.43% vs 2.02%; RR = .27; 95%CI: .12-.62; I2 = 0; P = .002), and they also had a lower bile duct drainage rate (24.8% vs 31.8% RR = .64, 95% CI: .44-.91, P = .01). Intraoperative complexes showed no statistically significant difference between the 2 groups (1.16% vs 9.24%; RR .17; 95%CI .03-1.02), but the incidence of intraoperative bleeding is lower in the ICG group. Conclusion ICG fluorescence imaging-assisted cholecystectomy was associated with a range of benefits, including a lower incidence of postoperative complications, decreased rates of bile leakage, reduced bile duct drainage, fewer intraoperative complications, and reduced intraoperative bleeding.

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“…Only few authors analyzed the risk of BDI for patients that underwent deferred urgent LC for chronic cholecystitis or complicated cholelithias is (acute gallstone pancreatitis, gallstones in the common bile duct previous treated with successful ERCP) [25][26]. Chronic in ammation, due to an infundibular impacted stone, may lead to adhesions, brosis with consequent reduction of the inferior angle of Calot's triangle, shortening of the cystic duct and nally biliary fusion between the gallbladder neck with the common hepatic duct.…”

Section: Surgical Outcomesmentioning

confidence: 99%

“…In six cases, no biliary structures were recognized, due to obesity, cirrhosis or scleroatrophic gallbladder. Obesity represents a limitation for NIRF-C, because NIR light has a penetration capability of only 5 to 10 mm [20][21][22][23][24][25][26][27]. On the other hand, in patients affected by cirrhosis, ICG failed to identify biliary structures due to technical issues, likely inadequate timing of injection before surgery.…”

Section: Surgical Outcomesmentioning

confidence: 99%

Utility of near infrared fluorescent cholangiography in detecting biliary structures during challenging minimally invasive cholecystectomy

Piccolo

Barabino

Lecchi

et al. 2023

Langenbecks Arch Surg

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BackgroundSurgeons can minimize the risk of bile duct injury (BDI) during challenging mini-invasive cholecystectomy through technical standardization by means of a precise anatomical landmark identi cation (Critical View of Safety) and advanced technology for biliary visualization. Among these systems, the adoption of magni ed stereoscopic 3-dimensional view provided by robotic platforms and near infrared uorescent cholangiography (NIRF-C) are the most promising. MethodsIn this prospective cohort study we evaluated all consecutive minimally invasive cholecystectomies (laparoscopic and robotic) performed with NIRF-C between May 2022 and January 2023 at

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Application of Intraoperative Fluorescence Imaging with Indocyanine Green in the Difficult Gallbladder: A Comparative Study between Indocyanine Green–Guided Fluorescence Cholangiography and Conventional Surgery

Cited by 9 publications

References 34 publications

Role of indocyanine green-guided near-infrared fluorescence imaging in identification of the cause of neonatal cholestasis

Role of indocyanine green-guided near-infrared fluorescence imaging in identification of the cause of neonatal cholestasis

Effects of Indocyanine Green (ICG) Imaging-Assisted Cholecystectomy on Intraoperative and Postoperative Complications: A meta-Analysis

Utility of near infrared fluorescent cholangiography in detecting biliary structures during challenging minimally invasive cholecystectomy

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