Clinical Application of Laparoscopic Cholecystectomy with Fluorescence Cholangiography of Indocyanine Green in the Difficult Cholecystectomy

Cheng ZHANG; Ning XU; Weisi LI; Yuntao ZHU; Min SUN

doi:10.12259/j.issn.2095-610X.S20220222

Volume 43 Issue 2

Mar. 2022

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Article Navigation > Journal of Kunming Medical University > 2022 > 43(2): 134-140

Cheng ZHANG, Ning XU, Weisi LI, Yuntao ZHU, Min SUN. Clinical Application of Laparoscopic Cholecystectomy with Fluorescence Cholangiography of Indocyanine Green in the Difficult Cholecystectomy[J]. Journal of Kunming Medical University, 2022, 43(2): 134-140. doi: 10.12259/j.issn.2095-610X.S20220222

Citation:

Cheng ZHANG, Ning XU, Weisi LI, Yuntao ZHU, Min SUN. Clinical Application of Laparoscopic Cholecystectomy with Fluorescence Cholangiography of Indocyanine Green in the Difficult Cholecystectomy[J]. Journal of Kunming Medical University, 2022, 43(2): 134-140. doi: 10.12259/j.issn.2095-610X.S20220222

Citation:

Cheng ZHANG, Ning XU, Weisi LI, Yuntao ZHU, Min SUN. Clinical Application of Laparoscopic Cholecystectomy with Fluorescence Cholangiography of Indocyanine Green in the Difficult Cholecystectomy[J]. Journal of Kunming Medical University, 2022, 43(2): 134-140. doi: 10.12259/j.issn.2095-610X.S20220222

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Clinical Application of Laparoscopic Cholecystectomy with Fluorescence Cholangiography of Indocyanine Green in the Difficult Cholecystectomy

doi: 10.12259/j.issn.2095-610X.S20220222

The 2nd Affiliated Hospital of Kunming Medical University，Kunming Yunnan 650101，China

Received Date: 2021-12-09
Available Online: 2022-02-24
Publish Date: 2022-03-04

Abstract

Abstract

Objective To study the safety, feasibility and reliability of indocyanine green fluorescence staining in laparoscopic cholecystectomy, whether it can effectively avoid bile duct injury, and to explore the shortcomings and advantages of indocyanine green fluorescence laparoscopic technology in difficult cholecystectomy. Methods The method of retrospective analysis was adopted, and the clinical data of patients meeting inclusion criteria for difficult cholecystectomy in 65 cases of cholecystectomies with the causes of the gallstone and recurrent cholecystitis in The Second Affiliated Hospital of Kunming Medical University from December 1, 2018 to December 1, 2019 were collected. All patients had signed the informed consent and had no history of iodine allergy. 65 patients were assigned randomly with 35 cases of laparoscopic cholecystectomy （LC） and 30 cases of laparoscopic cholecystectomy （LC） with fluorescence cholangiography of indocyanine green （ICG）. All kinds of the preoperative, intraoperative and postoperative data were collected to compare between the conventional group and cholangiography group. The application effect, safety and feasibility of the laparoscopic technologies with fluorescence cholangiography in the difficult cholecystectomy were explored, including whether the anatomic structure of the bile duct and the biliary tract time can be identified effectively. Results The time of laparoscopic cholecystectomy （LC） group was significantly longer than that of fluorescence cholangiography group （P < 0.05）; in terms of the time to isolate the anatomy of biliary tract, the time of fluorescence cholangiography group was significantly shorter than that of laparoscopic cholecystectomy （LC） group （P < 0.05）; the amount of bleeding in laparoscopic cholecystectomy （LC） was no statistically significant combined with fluorescence cholangiography group （P > 0.05）; there was no significant difference in length of stay （LOS） and all-in cost of stay between the two groups （P > 0.005）. Conclusions Indocyanine green fluorescence imaging laparoscopy has high operability and strong safety in identifying the anatomical structure of biliary tract in difficult cholecystectomy. It can effectively identify the anatomical structure of gallbladder triangle and effectively avoid the injury of biliary tract and blood vessels; Indocyanine green fluorescence imaging laparoscopic technology has the advantage of short operation time compared with traditional laparoscopic technology in Difficult Cholecystectomy, and there is no significant difference in postoperative liver function, infection index, hospitalization cycle and total hospitalization cost.
- Indocyanine green,
- Laparoscopic cholecystectomy,
- Biliary tract injury

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References(18)

References

[1]	Misawa T,Saito R,Shiba H,et al. Analysis of bile duct injuries (Stewart-Way classification)during laparoscopic cholecystectomy[J]. J Hepatobiliary Pancllatsurs,2006,13(5):427-434.
[2]	吲哚菁绿标记荧光腹腔镜技术在腹腔镜胃癌根治术中的应用专家共识[J]. 腹腔镜外科杂志, 2019, 24（5）: 395-400. DOI: 10.13499/j.cnki.fqjwkzz.2019.05.395.
[3]	文峰. 吲哚青绿血管造影术及其临床应用[J]. 眼科研究,2006(2):113-118.
[4]	Huang L,Vore M. Multidrug resistance p-glycoprotein 2 is essential for the biliary excretion of indocyanine green[J]. Drug Metab Dispos,2001,29(5):634-637.
[5]	Ishizawa T,Masuda K,Urano Y,et al. Mechanistic background and clinical applications of indocyanine green fluorescence imaging of hepatocellular carcinoma[J]. Ann Surg Oncol,2014,21(2):440-448. doi: 10.1245/s10434-013-3360-4
[6]	吲哚菁绿荧光染色在腹腔镜肝切除术中应用的专家共识[J]. 腹腔镜外科杂志, 2019, 24（5）: 388-394. DOI: 10.13499/j.cnki.fqjwkzz.2019.05.388.
[7]	雷光林,李媛媛,胡雄伟,洪智贤. 吲哚菁绿荧光染色技术在肝细胞癌合并肝硬化患者中行腹腔镜解剖性肝切除术的应用[J]. 肝胆胰外科杂志,2019,31(9):517-521.
[8]	LSF B,Handgraaf HJM,Huurman VAL,et al. The best approach for laparoscopic fluorescence cholangiography:overview of the literature and optimization of dose and dosing time[J]. Surg Innov,2017,24(4):386-396. doi: 10.1177/1553350617702311
[9]	Liu YY,Liao CH,Diana M,et al. Near-infrared cholecystocholangiography with direct intragallbladder indocyanine green injection:preliminary clinical results[J]. Surg Endosc,2018,32(3):1506-1514. doi: 10.1007/s00464-017-5838-9
[10]	Ankersmit M,Dam DA,Rijswijk AS,et al. Fluorescent imaging with indocyanine green during laparoscopic cholecystectomy in patients at increased risk of bile duct injury[J]. Surg Innov,2017,24(3):245-252. doi: 10.1177/1553350617690309
[11]	Ishizawa T,Bandai Y,Kokudo N. Fluorescent cholangiography using indocyanine green for laparoscopic cholecystectomy:an initial experience[J]. Arch Surg,2009,144(4):381-382. doi: 10.1001/archsurg.2009.9
[12]	雷泽华,高峰畏,赵欣,蒋康怡,谢青云,龚杰,乌建平,付金强,杜波,王志旭. 吲哚菁绿荧光显像技术在腹腔镜胆囊切除术中的应用初探[J]. 肝胆胰外科杂志,2019,31(9):522-525.
[13]	王坚. 困难腹腔镜胆囊切除应对策略[J]. 中国实用外科杂志,2015,35(9):947-950.
[14]	Thomson BN, Parks RW, Madhavan KK. et a1. Liver resection and transplantation in the management of
[15]	iatrogenic biliary injury. World J Surg,2007,31(12):2363-2369 Kern KA. Malpractice litigation involving laparoscopic cholecystec—tomy. Cost,cause,and consequences[J]. Arch Surg,1997,132(4):392-397. doi: 10.1001/archsurg.1997.01430280066009
[16]	Aoki T,Yasuda D,Shimizu Y,et al. Image-guided liver mapping using fluorescence navigation system with indocyanine green for anatomical hepatic resection[J]. World J Surg,2008,32(8):1763-1767. doi: 10.1007/s00268-008-9620-y
[17]	黄磊. 不同浓度吲哚菁绿在胆囊手术中的应用及其对肝功能的影响[J]. 肝脏,2019,24(7):800-802. doi: 10.14000/j.cnki.issn.1008-1704.2019.07.026
[18]	Ishizawa T,Bandai Y,Ijichi M,Kaneko J,Hasegawa K,Kokudo N. Fluorescent cholangiography illuminating the biliary tree during laparoscopic cholecystectomy[J]. Br J Surg,2010,97:1369-1377. doi: 10.1002/bjs.7125

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