Laparoscopic cholecystectomy (LC) is one of the most common operations in the surgical field. Bile duct injury is rare, with an incidence of 0.3% to 0.7%, but it can lead to serious consequences. Surgery for cholecystitis tends to be difficult for even experienced doctors and has a high risk of complication.
Intraoperative fluorescent imaging with indocyanine green (ICG) has been employed for confirming the patency of vascular reconstruction surgery, liver transplantation, anastomosis of the gastrointestinal tract, brain aneurysms, identification of sentinel lymph node navigation, and hepatocellular carcinoma detection. Recently, an intraoperative cholangiography technique in LC involving the excretion of fluorescent ICG in the bile after intravenous injection has been used to determine the bile duct anatomy. Currently, some detailed reports have been published on LC using intraoperative ICG cholangiography and suggested its safety and feasibility.
We performed cholecystectomy in 40 year old female with impacted calculus of 20 mm size in cystic duct. With help of ICG , it was easy to delineate biliary tree and during whole dissection we were able to identify CBD and CD preventing injury to bile duct.
ICG is being increasingly used during laparoscopic cholecystectomy to better understand the anatomy of the biliary tree and prevent or reduce the risk of bile duct injury.