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

Piccolo, Gaetano; Barabino, Matteo; Lecchi, Francesca; Formisano, Giampaolo; Salaj, Adelona; Piozzi, Guglielmo Niccolò; Bianchi, Paolo Pietro

doi:10.1007/s00423-023-02995-1

Langenbecks Arch Surg

2023

DOI: 10.1007/s00423-023-02995-1

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

Gaetano Piccolo

Matteo Barabino

Francesca Lecchi

et al.

Abstract: 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 eval… Show more

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2024

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Cited by 2 publications

References 27 publications

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Utility of Fluorescent Cholangiography via Nasobiliary Tube in Difficult Laparoscopic Cholecystetomy

Chu,

Li,

Gao

2024

Videoscopy

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Utility of Fluorescent Cholangiography via Nasobiliary Tube in Difficult Laparoscopic Cholecystetomy

Chu,

Li,

Gao

2024

Videoscopy

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The role of fluorescent cholangiography to improve operative safety in different severity degrees of acute cholecystitis during emergency laparoscopic cholecystectomy: a prospective cohort study

Pesce,

Fabbri,

Bonazza

et al. 2024

International Journal of Surgery

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Background: Currently, there is limited scientific evidence regarding the effectiveness of fluorescent cholangiography in emergency cholecystectomy for acute cholecystitis. The primary aim of this study was to assess the efficacy of near-infrared fluorescent cholangiography (NIRF-C) in different severity degrees of acute cholecystitis. Materials and methods: Inclusion criteria were patients with a clinical and radiological (abdominal ultrasound and/or computed tomography) diagnosis of acute cholecystitis based on the revised 2018 Tokyo guidelines who underwent laparoscopic cholecystectomy within 24-72 hours from the onset of symptoms and patients with ASA score of 0-3. NIRF-C was performed at three time points during laparoscopic cholecystectomy: (i) following exposure of Calot’s triangle, prior to any dissection; (ii) after partial dissection of Calot’s triangle; (iii) after complete dissection of Calot’s triangle. The intra-operative severity degree of acute cholecystitis was assessed according to the American Association of Surgery for Trauma (AAST) classification. Result: NIRF-C was successfully performed in all 81 consecutive patients who underwent emergency laparoscopic cholecystectomy. The cystic duct was identified by NIRF-C in 46 (56.8%) and 77 (95.1%) of the 81 patients before and after Calot’s dissection, respectively. The common hepatic duct and common bile duct were successfully identified in 11 (13.6%) and 32 patients (39.5%) before Calot’s dissection, respectively, and in 45 (55.6%) and 76 patients (93.8%) after complete Calot’s dissection, respectively. When comparing the visualization rate of biliary structures before and after Calot dissection in different severity degrees of cholecystitis, we found a statistically significant difference in non-gangrenous (AAST I) versus gangrenous and complicated forms (AAST II-V) for all biliary structures, both before and after Calot’s dissection. Conclusion: The study indicates that the use of fluorescence cholangiography during emergency laparoscopic cholecystectomy for acute cholecystitis may represent a valuable and useful tool for intraoperative visualization of the extrahepatic biliary tract.

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

Cited by 2 publications

References 27 publications

Utility of Fluorescent Cholangiography via Nasobiliary Tube in Difficult Laparoscopic Cholecystetomy

Utility of Fluorescent Cholangiography via Nasobiliary Tube in Difficult Laparoscopic Cholecystetomy

The role of fluorescent cholangiography to improve operative safety in different severity degrees of acute cholecystitis during emergency laparoscopic cholecystectomy: a prospective cohort study

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