Fluorescent cholangiography with direct injection of indocyanine green (ICG) into the gallbladder: a safety method to outline biliary anatomy

Škrabec, Clara Gené; Aranda, Fernando; Espín, Francisco; Pérez, Manel Cremades; Navinés, Jordi; Zárate, Alba; Cugat, Esteban

doi:10.1007/s00423-020-01967-z

Cited by 28 publications

(30 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…ICG fluorescence imaging is widely used in various fields such as for the identification of sentinel lymph nodes in several malignancies, the evaluation of adequate perfusion after cardiovascular grafting and hepatobiliary surgery. 1,[11][12][13][14][15][16] In 2008, our team first showed that ICG fluorescence imaging was extremely useful for clearly demarcating the liver segments prior to anatomical liver resection. 13 Subsequently, the efficacy of NIFC for the identification of subcapsular hepatic tumors and securing the surgical margin in hepatobiliary surgery was widely reported.…”

Section: Discussionmentioning

confidence: 99%

“…1,[11][12][13][14][15][16] In 2008, our team first showed that ICG fluorescence imaging was extremely useful for clearly demarcating the liver segments prior to anatomical liver resection. 13 Subsequently, the efficacy of NIFC for the identification of subcapsular hepatic tumors and securing the surgical margin in hepatobiliary surgery was widely reported. 12,14 Ishizawa et al first demonstrated the effectiveness of intraoperative cholangiography.…”

Section: Discussionmentioning

confidence: 99%

“…[28][29][30][31] One of the advantages of this method over intravenous injection is the ability to obtain a clear view of the biliary structure because of the absence of fluoresce noise from the liver. The rate of the identification of the biliary tract for cases with ICG direct injection in this study was better than that described in a previous report, [28][29][30][31] possibly due to a lower concentration of ICG being used and the avoidance of an excessive fluorescent signal. NIFS with direct ICG injection was shown to be particularly effective especially for patients who underwent PTGBD preoperatively for acute cholecystitis.…”

Section: CDmentioning

confidence: 99%

“…Laparoscopic fluorescence imaging systems have become commercially available, and their usefulness during hepatectomy has been widely reported. Our team first demonstrated that ICG fluorescence imaging was extremely useful for clearly demarcating the liver segments prior to anatomical liver resection 13 and determining of the surgical margin. 14 In 2009, Ishizawa et al reported the usefulness of ICG fluorescence cholangiography during hepatectomy.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

The Efficacy of Intraoperative Fluorescent Imaging Using Indocyanine Green for Cholangiography During Cholecystectomy and Hepatectomy

Shibata¹,

Aoki²,

Koizumi³

et al. 2021

CEG

View full text Add to dashboard Cite

Purpose Bile duct injury is one of the most serious complications of laparoscopic cholecystectomy. Intraoperative indocyanine green (ICG) cholangiography is a safe and useful navigation modality for confirming the biliary anatomy. ICG cholangiography is expected to be a routine method for helping avoid bile duct injuries. Patients and Methods We examined 25 patients who underwent intraoperative cholangiography using ICG fluorescence. Two methods of ICG injection are used: intrabiliary injection (percutaneous transhepatic gallbladder drainage [PTGBD], gallbladder [GB] puncture and endoscopic nasobiliary drainage [ENBD]) at a dosage of 0.025 mg during the operation or intravenous injection with 2.5 mg ICG preoperatively. Results There were 24 patients who underwent laparoscopic cholecystectomy and 1 patient who underwent hepatectomy. For laparoscopic cholecystectomy, the average operation time was 127 (50–197) minutes, and estimated blood loss was 43.2 (0–400) g. The ICG administration route was intravenous injections in 12 cases and intrabiliary injection in 12 cases (GB injection: 3 cases, PTGBD: 8 cases, ENBD:1 case). The course of the biliary tree was able to be confirmed in all cases that received direct injection into the biliary tract, whereas bile structures were recognizable in only 10 cases (83.3%) with intravenous injection. The postoperative hospital stay was 4.6 (3–9) days, and no postoperative complications (Clavien–Dindo ≧IIIa) were observed. For hepatectomy, a tumor located near the left Glissonian pedicle was resected using a fluorescence image guide. Biliary structures were fluorescent without injury after resecting the tumor. No adverse events due to ICG administration were observed, and the procedure was able to be performed safely. Conclusion ICG fluorescence imaging allows surgeons to visualize the course of the biliary tree in real time during cholecystectomy and hepatectomy. This is considered essential for hepatobiliary surgery to prevent biliary tree injury and ensure safe surgery.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: CDmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The Efficacy of Intraoperative Fluorescent Imaging Using Indocyanine Green for Cholangiography During Cholecystectomy and Hepatectomy

Shibata¹,

Aoki²,

Koizumi³

et al. 2021

CEG

View full text Add to dashboard Cite

show abstract

“…11, 28 For cholangiography by direct ICG injection to gallbladder, 0.0025 2.5 mg/mL of ICG was administrated. [29][30][31] In this case, 0.25 mg/mL ICG was injected directly via the sinus orifice until the confirmation of back flow. The sinus tract that could not be identified by white color light was immediately identified with clear fluorescent at this concentration.…”

Section: Discussionmentioning

confidence: 99%

Indocyanine green fluorescence‐guided laparoscopic removal of infected mesh with chronic sinus formation after inguinal mesh plug repair

Shimada

Hirose

Matsubara

et al. 2021

Asian J Endoscop Surgery

View full text Add to dashboard Cite

Chronic mesh infection with sinus formation is usually amenable to open method with dye. Recently, intraoperative real-time fluorescent imaging has been applied to various organs but not to mesh infection. A 72-year-old man with the history of two times removal of infected mesh was referred for groin bulge with purulent discharge. Laparoscopy assisted infected mesh removal was undertaken using intraoperative real-time fluorescent imaging with indocyanine green injection via the sinus orifice. We experienced the first case of the infected mesh with chronic sinus formation treated by the help of intraoperative indocyanine green fluorescent. This method is simple and easy to apply for laparoscopic assisted removal of chronic mesh infection with sinus.

show abstract

Indocyanine green for targeted imaging of the gall bladder and fluorescence navigation

Wang

Yang

Mei

et al. 2022

Journal of Biophotonics

View full text Add to dashboard Cite

Researchers nowadays have devoted extra attention to the different biomedical applications of indocyanine green (ICG), a US Food and Drug Administration‐approved fluorescent compound in the fields such as drug delivery, medical imaging and disease diagnosis. In addition, hepatic function evaluation could be conducted by using ICG before surgical procedures and angiographic assessment of blood. Therefore, ICG will be expected to be excellent imaging and targeting agent in various preclinical and clinical model systems. However, whether ICG possesses the potential for the gall bladder's intraoperative imaging guidance needs to be further explored in vivo animal experiments. Herein, near‐infrared fluorophores ICG can display the specific uptake by the gall bladder cells and tissues. The dynamic process of biodistribution and the clearance of ICG in vivo in mice are clearly shown in real‐time live‐body imaging. Furthermore, ICG was rapidly excreted into the bile and lately biodistributed to the stomach after treatment in mice. Meanwhile, the signal‐to‐background ratio of the gall bladder demonstrated a tremendously higher level compared to other organs (stomach, heart, liver, lung, pancreas, spleen, intestine and duodenum). In conclusion, fluorescence navigation using ICG fluorescence imaging will provide good visualization and detection of the target lesions (gall bladder) in clinics such as diagnostic medical imaging and intraoperative navigation.

show abstract

Fluorescent cholangiography with direct injection of indocyanine green (ICG) into the gallbladder: a safety method to outline biliary anatomy

Cited by 28 publications

References 18 publications

The Efficacy of Intraoperative Fluorescent Imaging Using Indocyanine Green for Cholangiography During Cholecystectomy and Hepatectomy

The Efficacy of Intraoperative Fluorescent Imaging Using Indocyanine Green for Cholangiography During Cholecystectomy and Hepatectomy

Indocyanine green fluorescence‐guided laparoscopic removal of infected mesh with chronic sinus formation after inguinal mesh plug repair

Indocyanine green for targeted imaging of the gall bladder and fluorescence navigation

Contact Info

Product

Resources

About