Indocyanine Green Imaging in Laparoscopic Cholecystectomy Plus Laparoscopic Common Bile Duct Exploration: A Suitable Option for Patients With Difficult Exploration (With Videos)

Abstract

Background: The clinical application of indocyanine green (ICG) fluorescence imaging technology in biliary surgery has gradually highlighted its role, and its role in laparoscopic cholecystectomy plus laparoscopic common bile duct exploration (LC+LCBDE) still needs to be further explored. Therefore, we evaluated the clinical value of ICG fluorescence imaging in LC+LCBDE.

Materials and methods: Data from 131 patients who underwent LC+LCBDE in our department between January 2019 and June 2021 were retrospectively collected and analyzed. Overall, 59 and 72 patients underwent ICG+LC+LCBDE and LC+LCBDE, respectively, and were assigned to the ICG (ICG+LC+LCBDE) and non-ICG (LC+LCBDE) groups based on their medical records. The clinical data of all patients were obtained, and the differences between the ICG and non-ICG groups were compared.

Results: A total of 131 patients successfully underwent surgery. There were no differences in baseline characteristics between the 2 groups. In terms of perioperative results, no significant between-group differences in biliary tract exposure before Calot's triangle dissection were noted; however, patients in the ICG group had better biliary tract observations after Calot's triangle dissection, shorter operative time, fewer complications, earlier postoperative exhaust, and lower hospital costs.

Conclusions: ICG imaging can assist surgeons in determining biliary tract structures and injuries during surgery and in preventing operation-related bile leakage. ICG imaging is a technique worthy of promotion in difficult surgery.