Non-radiographic intraoperative fluorescent cholangiography is feasible

INTRODUCTION: Intraoperative fluorescent cholangiography (IFC) with concomitant fluorescent angiography was recently developed for non-invasive identification of the anatomy during laparoscopic cholecystectomy. The objective of this study was to assess the time required for routine-use of IFC and to evaluate the success rate of the procedures.

MATERIAL AND METHODS: A total of 35 patients scheduled for laparoscopic cholecystectomy and operated by the same surgeon were consecutively enrolled. A standardised protocol with IFC including angiography was performed during laparoscopic cholecystectomy. Intraoperative time and exposure of predefined anatomical structures were recorded.

RESULTS: The median time used for IFC was 2.6 minutes (range: 1.5-11.4 minutes) corresponding to a median of 6.2% (range: 3.0-15.2%) of the operation time. The junction between the cystic duct, the common bile duct and the common hepatic duct was identified by IFC in all patients. In 29 of the 35 patients (83%; 95% confidence interval: 71-96%), the cystic artery was visualised by fluorescent angiography. No adverse effects or complications were recorded.

CONCLUSION: Routine-use of IFC with fluorescent angiography during laparoscopic cholecystectomy is feasible and associated with an acceptable time expenditure and a satisfactory success-rate.

FUNDING: Not relevant.

TRIAL REGISTRATION: The Regional Ethics Committee approved the study (J. No. H-3-2013-FSP45). The study is registered with clinicaltrials.gov (ID: NCT02136095).