| Peer-Reviewed

Indocyanine Green Fluorescence–Guided Avoidance of Bile Duct Injury During Simultaneous Laparoscopic Fenestration and Cholecystectomy

Received: 22 September 2022     Accepted: 8 October 2022     Published: 17 October 2022
Views:       Downloads:
Abstract

Real-time indocyanine green (ICG) guided surgery has been reported to be safe for cholangiography in laparoscopic cholecystectomy (LC). Laparoscopic fenestration (LF) is a standard and safe procedure for liver cysts. However, no cases had been reported for simultaneous treatment of fenestration and cholecystectomy using ICG guided laparoscopic surgery. In this presented study, a case of successful simultaneous treatment of LF and LC was reported using ICG to prevent biliary injury. A 72-year-old man diagnosed with multiple hepatic cysts and gallstones was given 0.1 mg ICG intravenously 20 min before surgery. ICG cholangiography clearly showed the common bile duct and the liver parenchyma for LC. The cystohepatic triangle was safely dissected without injuring the common bile duct using the merge view mode. ICG fluorescence cholangiography clearly showed the biliary ducts inside the cyst and distinguished the wall of cysts from parenchyma. Only the cyst walls were resected to the greatest extent possible without injuring surrounding bile ducts. With the administration of 0.1 mg ICG intravenously 20 min before surgery, real-time ICG guided surgery is safe for simultaneous LF and LC for avoidance of bile duct injury. In conclusion, administration of 0.1 mg ICG intravenously 20 min before surgery is an applicable dose and timing for ICG guided simultaneous LF and LC and deserves popularization.

Published in Clinical Medicine Research (Volume 11, Issue 5)
DOI 10.11648/j.cmr.20221105.15
Page(s) 145-149
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2022. Published by Science Publishing Group

Keywords

Indocyanine Green, Laparoscopic Fenestration, Laparoscopic Cholecystectomy, Cholangiography, Hepatic Cysts

References
[1] Bernts LHP, Echternach SG, Kievit W, Rosman C & Drenth JPH (2019) Clinical response after laparoscopic fenestration of symptomatic hepatic cysts : a systematic review and meta-analysis. Surg Endosc 33, 691–704.
[2] Shimizu T, Yoshioka M, Kaneya Y, Kanda T, Aoki Y, Kondo R, Takata H, Ueda J, Kawano Y, Hirakata A, Matsushita A, Taniai N, Mamada Y & Yoshida H (2022) Management of Simple Hepatic Cyst. J Nippon Med Sch 89, 2–8.
[3] Schnelldorfer T, Torres VE, Zakaria S, Rosen CB & Nagorney DM (2009) Polycystic Liver Disease. Ann Surg 250, 112–118.
[4] Pucher PH, Brunt LM, Davies N, Linsk A, Munshi A, Rodriguez HA, Fingerhut A, Fanelli RD, Asbun H, Aggarwal R & SAGES Safe Cholecystectomy Task Force (2018) Outcome trends and safety measures after 30 years of laparoscopic cholecystectomy: a systematic review and pooled data analysis. Surg Endosc 32, 2175–2183.
[5] Deziel DJ, Millikan KW, Economou SG, Doolas A, Ko ST & Airan MC (1993) Complications of laparoscopic cholecystectomy: a national survey of 4,292 hospitals and an analysis of 77,604 cases. Am J Surg 165, 9–14.
[6] Flum DR, Dellinger EP, Cheadle A, Chan L & Koepsell T (2003) Intraoperative cholangiography and risk of common bile duct injury during cholecystectomy. JAMA 289, 1639–44.
[7] Giger U, Ouaissi M, Schmitz S-FH, Krähenbühl S & Krähenbühl L (2011) Bile duct injury and use of cholangiography during laparoscopic cholecystectomy. Br J Surg 98, 391–6.
[8] Chen Q, Zhou R, Weng J, Lai Y, Liu H, Kuang J, Zhang S, Wu Z, Wang W & Gu W (2021) Extrahepatic biliary tract visualization using near-infrared fluorescence imaging with indocyanine green: optimization of dose and dosing time. Surg Endosc 35, 5573–5582.
[9] Boni L, David G, Mangano A, Dionigi G, Rausei S, Spampatti S, Cassinotti E & Fingerhut A (2015) Clinical applications of indocyanine green (ICG) enhanced fluorescence in laparoscopic surgery. Surg Endosc 29, 2046–55.
[10] Paterson-Brown S & Garden OJ (1991) Laser-assisted laparoscopic excision of liver cyst. Br J Surg 78, 1047.
[11] Z’graggen K, Metzger A & Klaiber C (1991) Symptomatic simple cysts of the liver: treatment by laparoscopic surgery. Surg Endosc 5, 224–5.
[12] Tanaka M, Inoue Y, Mise Y, Ishizawa T, Arita J, Takahashi Y & Saiura A (2016) Laparoscopic deroofing for polycystic liver disease using laparoscopic fusion indocyanine green fluorescence imaging. Surg Endosc 30, 2620–2623.
[13] Kitajima T, Fujimoto Y, Hatano E, Mitsunori Y, Tomiyama K, Taura K, Mizumoto M & Uemoto S (2015) Intraoperative fluorescent cholangiography using indocyanine green for laparoscopic fenestration of nonparasitic huge liver cysts. Asian J Endosc Surg 8, 71–74.
[14] Umemura A, Nitta H, Suto T, Fujiwara H, Takahara T, Hasegawa Y, Katagiri H, Kanno S, Ando T & Sasaki A (2021) Indocyanine green fluorescence imaging via endoscopic nasal biliary drainage during laparoscopic deroofing of liver cysts. J Minim Access Surg 17, 131–134.
[15] Hanaki T, Yagyu T, Uchinaka E, Morimoto M, Watanabe J, Tokuyasu N, Takano S, Sakamoto T, Honjo S & Fujiwara Y (2020) Avoidance of bile duct injury during laparoscopic liver cyst fenestration using indocyanine green: A case report. Clin Case Reports 8, 1419–1424.
[16] Une N, Fujio A, Mitsugashira H, Kanai N, Saitoh Y, Ohta M, Sasaki K, Miyazawa K, Kashiwadate T, Nakanishi W, Tokodai K, Miyagi S, Unno M & Kamei T (2021) Laparoscopic liver cyst fenestration with real-time indocyanine green fluorescence-guided surgery: a case report. J Surg Case Reports 2021, 1–4.
[17] Tanioka N, Maeda H, Shimizu S, Munekage M, Uemura S & Hanazaki K (2021) Indocyanine green fluorescence-guided laparoscopic deroofing of a liver cyst: A case report. Asian J Endosc Surg, 12–15.
Cite This Article
  • APA Style

    Hui Liu, Jiao Kuang, Yu Huang, Shuai Zhang, Jiefeng Weng, et al. (2022). Indocyanine Green Fluorescence–Guided Avoidance of Bile Duct Injury During Simultaneous Laparoscopic Fenestration and Cholecystectomy. Clinical Medicine Research, 11(5), 145-149. https://doi.org/10.11648/j.cmr.20221105.15

    Copy | Download

    ACS Style

    Hui Liu; Jiao Kuang; Yu Huang; Shuai Zhang; Jiefeng Weng, et al. Indocyanine Green Fluorescence–Guided Avoidance of Bile Duct Injury During Simultaneous Laparoscopic Fenestration and Cholecystectomy. Clin. Med. Res. 2022, 11(5), 145-149. doi: 10.11648/j.cmr.20221105.15

    Copy | Download

    AMA Style

    Hui Liu, Jiao Kuang, Yu Huang, Shuai Zhang, Jiefeng Weng, et al. Indocyanine Green Fluorescence–Guided Avoidance of Bile Duct Injury During Simultaneous Laparoscopic Fenestration and Cholecystectomy. Clin Med Res. 2022;11(5):145-149. doi: 10.11648/j.cmr.20221105.15

    Copy | Download

  • @article{10.11648/j.cmr.20221105.15,
      author = {Hui Liu and Jiao Kuang and Yu Huang and Shuai Zhang and Jiefeng Weng and Yueyuan Lai and Zhaofeng Wu and Keqiang Ma and Weili Gu},
      title = {Indocyanine Green Fluorescence–Guided Avoidance of Bile Duct Injury During Simultaneous Laparoscopic Fenestration and Cholecystectomy},
      journal = {Clinical Medicine Research},
      volume = {11},
      number = {5},
      pages = {145-149},
      doi = {10.11648/j.cmr.20221105.15},
      url = {https://doi.org/10.11648/j.cmr.20221105.15},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cmr.20221105.15},
      abstract = {Real-time indocyanine green (ICG) guided surgery has been reported to be safe for cholangiography in laparoscopic cholecystectomy (LC). Laparoscopic fenestration (LF) is a standard and safe procedure for liver cysts. However, no cases had been reported for simultaneous treatment of fenestration and cholecystectomy using ICG guided laparoscopic surgery. In this presented study, a case of successful simultaneous treatment of LF and LC was reported using ICG to prevent biliary injury. A 72-year-old man diagnosed with multiple hepatic cysts and gallstones was given 0.1 mg ICG intravenously 20 min before surgery. ICG cholangiography clearly showed the common bile duct and the liver parenchyma for LC. The cystohepatic triangle was safely dissected without injuring the common bile duct using the merge view mode. ICG fluorescence cholangiography clearly showed the biliary ducts inside the cyst and distinguished the wall of cysts from parenchyma. Only the cyst walls were resected to the greatest extent possible without injuring surrounding bile ducts. With the administration of 0.1 mg ICG intravenously 20 min before surgery, real-time ICG guided surgery is safe for simultaneous LF and LC for avoidance of bile duct injury. In conclusion, administration of 0.1 mg ICG intravenously 20 min before surgery is an applicable dose and timing for ICG guided simultaneous LF and LC and deserves popularization.},
     year = {2022}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - Indocyanine Green Fluorescence–Guided Avoidance of Bile Duct Injury During Simultaneous Laparoscopic Fenestration and Cholecystectomy
    AU  - Hui Liu
    AU  - Jiao Kuang
    AU  - Yu Huang
    AU  - Shuai Zhang
    AU  - Jiefeng Weng
    AU  - Yueyuan Lai
    AU  - Zhaofeng Wu
    AU  - Keqiang Ma
    AU  - Weili Gu
    Y1  - 2022/10/17
    PY  - 2022
    N1  - https://doi.org/10.11648/j.cmr.20221105.15
    DO  - 10.11648/j.cmr.20221105.15
    T2  - Clinical Medicine Research
    JF  - Clinical Medicine Research
    JO  - Clinical Medicine Research
    SP  - 145
    EP  - 149
    PB  - Science Publishing Group
    SN  - 2326-9057
    UR  - https://doi.org/10.11648/j.cmr.20221105.15
    AB  - Real-time indocyanine green (ICG) guided surgery has been reported to be safe for cholangiography in laparoscopic cholecystectomy (LC). Laparoscopic fenestration (LF) is a standard and safe procedure for liver cysts. However, no cases had been reported for simultaneous treatment of fenestration and cholecystectomy using ICG guided laparoscopic surgery. In this presented study, a case of successful simultaneous treatment of LF and LC was reported using ICG to prevent biliary injury. A 72-year-old man diagnosed with multiple hepatic cysts and gallstones was given 0.1 mg ICG intravenously 20 min before surgery. ICG cholangiography clearly showed the common bile duct and the liver parenchyma for LC. The cystohepatic triangle was safely dissected without injuring the common bile duct using the merge view mode. ICG fluorescence cholangiography clearly showed the biliary ducts inside the cyst and distinguished the wall of cysts from parenchyma. Only the cyst walls were resected to the greatest extent possible without injuring surrounding bile ducts. With the administration of 0.1 mg ICG intravenously 20 min before surgery, real-time ICG guided surgery is safe for simultaneous LF and LC for avoidance of bile duct injury. In conclusion, administration of 0.1 mg ICG intravenously 20 min before surgery is an applicable dose and timing for ICG guided simultaneous LF and LC and deserves popularization.
    VL  - 11
    IS  - 5
    ER  - 

    Copy | Download

Author Information
  • Department of Hepatobiliary Pancreatic Surgery, Guangzhou First People’s Hospital, Guangzhou, China

  • Department of Hepatobiliary Pancreatic Surgery, Guangzhou First People’s Hospital, Guangzhou, China

  • Department of Hepatobiliary Pancreatic Surgery, Guangzhou First People’s Hospital, Guangzhou, China

  • Department of Hepatobiliary Pancreatic Surgery, Guangzhou First People’s Hospital, Guangzhou, China

  • Department of Hepatobiliary Pancreatic Surgery, Guangzhou First People’s Hospital, Guangzhou, China

  • Department of Hepatobiliary Pancreatic Surgery, Guangzhou First People’s Hospital, Guangzhou, China

  • Department of Hepatobiliary Pancreatic Surgery, Guangzhou First People’s Hospital, Guangzhou, China

  • Department of Hepatobiliary Pancreatic Surgery, Affiliated Huadu Hospital, Southern Medical University, Guangzhou, China

  • Department of Hepatobiliary Pancreatic Surgery, Guangzhou First People’s Hospital, Guangzhou, China

  • Sections