Intraoperative Laparoscopic Near-Infrared Fluorescence Cholangiography to Facilitate Anatomical Identification: When to Give Indocyanine Green and How Much

Ali Zarrinpar, Erik P. Dutson, Constance M. Mobley, Ronald W. Busuttil, Catherine E. Lewis, Areti Tillou, Ali Cheaito, O. Joe Hines, Vatche G. Agopian, Darryl T. Hiyama

Research output: Contribution to journalArticle

20 Scopus citations

Abstract

Recent technological advances have enabled real-time near-infrared fluorescence cholangiography (NIRFC) with indocyanine green (ICG). Whereas several studies have shown its feasibility, dosing and timing for practical use have not been optimized. We undertook a prospective study with systematic variation of dosing and timing from injection of ICG to visualization. Adult patients undergoing laparoscopic biliary and hepatic operations were enrolled. Intravenous ICG (0.02-0.25 mg/kg) was administered at times ranging from 10 to 180 minutes prior to planned visualization. The porta hepatis was examined using a dedicated laparoscopic system equipped to detect NIRFC. Quantitative analysis of intraoperative fluorescence was performed using a scoring system to identify biliary structures. A total of 37 patients were enrolled. Visualization of the extrahepatic biliary tract improved with increasing doses of ICG, with qualitative scores improving from 1.9 ± 1.2 (out of 5) with a 0.02-mg/kg dose to 3.4 ± 1.3 with a 0.25-mg/kg dose (P

Original languageEnglish (US)
Pages (from-to)360-365
Number of pages6
JournalSurgical Innovation
Volume23
Issue number4
DOIs
StatePublished - Aug 1 2016

Keywords

  • biliary anatomy
  • infrared fluorescence
  • intraoperative cholangiography
  • intraoperative guidance

ASJC Scopus subject areas

  • Surgery

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