BACKGROUND Incisionless fluorescent cholangiography (IFC) has recently been proven feasible, safe, and efficacious as an intraoperative procedure to help identify extrahepatic bile ducts during laparoscopic cholecystectomies (LC). We conducted a pilot survey of 51 surgeons attending an international conference who perform endoscopic cholecystectomies to identify their typical LC practices, and perceptions of IFC. METHODS An international panel of ten IFC experts, all with > 500 prior IFC procedures and related research publications, convened during the 4th International Congress of Fluorescence-Guided Surgery in Boca Raton, Florida in February 2017. The panel was charged with developing questions about LC practices and experience with IFC, and perceptions regarding its advantages, barriers to use, and indications. These questions then were asked to other congress attendees during one of the didactic sessions using an online polling application. Attendees, who ranged from zero to considerable experience performing IFC, accessed the survey via their portable devices. RESULTS Of the 51 survey participants, 51% were from North America; 77% identified themselves as general/minimally invasive surgeons, and roughly 60% performed under 50 cholecystectomies/year. Only 12% performed routine intraoperative cholangiography (IOC), while 72.3% routinely performed critical safety reviews. Thirty-five percent estimated that their institution's laparoscopic-to-open surgery conversion rate was > 1% during LC. Roughly 95% of respondents felt that surgeons should have access to a noninvasive method for evaluating extrahepatic biliary structures; 84% felt that the most advantageous characteristic of IFC is the lack of any biliary-tree incision; and 93.3% felt that IFC would have considerable educational value in surgical training programs; and 78% felt that any surgeon who performs LC could benefit. CONCLUSIONS Surgeons who participated in our survey overwhelmingly recommended the routine use of IFC during laparoscopic cholecystectomy as a complimentary imaging technique. Prospective randomized clinical trials remain necessary to determine whether IFC reduces the incidence of bile duct injuries and other LC complications.

中文翻译：

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无切口荧光胆道造影（IFC）：对外科医生进行程序熟悉性，实践和感知的先导调查。

背景技术近来，无切口荧光胆管造影术（IFC）已被证明是可行的，安全的和有效的，作为一种术中程序，有助于在腹腔镜胆囊切除术（LC）期间识别肝外胆管。我们对参加一次国际会议的51位外科医生进行了一项试点调查，他们进行了内窥镜胆囊切除术，以确定他们的典型LC操作和对IFC的看法。方法2017年2月在佛罗里达州博卡拉顿举行的第四届国际荧光引导手术大会上召集了一个由10名IFC专家组成的国际小组，所有小组均具有> 500项先前的IFC程序和相关研究出版物。该小组负责解决有关LC的问题IFC的实践和经验，以及对其优势，使用障碍和适应症的看法。然后，在其中的一次教学会议期间，使用在线投票应用程序将这些问题询问给其他与会代表。参加会议的人从零到具有丰富的执行IFC经验，他们都通过便携式设备访问了调查。结果在51名调查参与者中，有51％来自北美；其中50％来自北美。77％的人认为自己是普通/微创外科医师，大约60％的人每年做50例胆囊切除术。只有12％的人进行了常规术中胆管造影（IOC），而72.3％的人则进行了严格的安全性检查。35％的人估计他们所在机构在LC期间，腹腔镜转开腹手术的转化率> 1％。大约95％的受访者认为，外科医生应该可以采用非侵入性的方法来评估肝外胆道结构。84％的人认为IFC最有利的特征是没有任何胆道切口；93.3％的人认为国际金融公司在外科手术培训计划中具有相当的教育价值；78％的人认为执行LC的任何外科医生都可以受益。结论参加本次调查的外科医生绝大多数建议在腹腔镜胆囊切除术中常规使用IFC作为辅助成像技术。确定IFC是否可降低胆管损伤和其他LC并发症的发生率，仍需进行前瞻性随机临床试验。结论参加本次调查的外科医生绝大多数建议在腹腔镜胆囊切除术中常规使用IFC作为辅助成像技术。确定IFC是否可降低胆管损伤和其他LC并发症的发生率，仍需进行前瞻性随机临床试验。结论参加本次调查的外科医生绝大多数建议在腹腔镜胆囊切除术中常规使用IFC作为辅助成像技术。确定IFC是否可降低胆管损伤和其他LC并发症的发生率，仍需进行前瞻性随机临床试验。