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Laparoscopic cholecystectomy with intraoperative ICG. Is this a means of improving the safety of laparoscopic cholecystectomy?
13 August 2018 (online)
Laparoscopic cholecystectomy (LC) represents one of the most commonly performed surgical procedures in Germany. Bile duct injury represents the most serious complication of this procedures with reported rates ranging between 0.4 – 4.8%. Thus bile duct injury has been used as the most relevant quality indicator for LC. Intraoperative imaging with ICG enables a better visualization of the biliary systems and thus might play a key role in preventing bile duct injury. Herein, we report our initial results on the use of ICG in the management of patients with gallbladder disorders.
Material and methods:
We retrospectively compared the findings of patients undergoing LC for biliary disorders. The study group consisted of patients undergoing LC with ICG while the control group included patients undergoing LC without intraoperative ICG. Outcome included the rate of bile duct injury, the duration of surgery and the rate of conversion. In the study group, i.v ICG was applied one hour prior to surgery. To exclude the effect of surgeon's expertise, only patients managed by a single surgeon (KZ) were included for analysis.
70 patients, 30 females and 40 males with a mean age of 60.8 25.4yrs were included for analysis. 29 patients were managed with ICG while 41 patients underwent LC without ICG. There was no statistically significant difference amongst both groups with regard to baseline characteristics. The mean duration of surgery was 60.9 ± 25.9 min in the ICG group and 60.7 ± 25.2 min, p = 0.98. The other outcome measures were comparable in both groups.
Despite a better visualization of the biliary tree in the ICG group, no significant difference was found between patients undergoing LC with or without ICG.