BACKGROUND The aim is to evaluate safety and efficacy of near infra-red (NIR) indocyanine green (ICG) fluorescence structural imaging during laparoscopic cholecystectomy (LC) (Group A) and to compare perioperative data, including operative time, with a series of patients who underwent LC with routine traditional intraoperative cholangiography (IOC) (Group B). METHODS Forty-four patients with acute or chronic cholecystitis underwent NIR-ICG fluorescent cholangiography during LC. ICG was administered intravenously at different time intervals or by direct gallbladder injection during surgery. Fluorescence intensity and anatomy identification were scored according to a visual analogue scale between 1 (least accurate) and 5 (most accurate). Group B patients (n = 44) were chosen from a prospectively maintained database of patients who underwent LC with routine IOC, matched for age, sex, body mass index, and diagnosis with group A patients. RESULTS No adverse reactions were recorded. In group A, mean time between intravenous administration of ICG and surgery was 10.7 ± 8.2 (range 2-52) h. Administered doses ranged from 3.5 to 13.5 mg. Fluorescence was present in all cases, scoring ≥ 3 in 41 patients. Mean operative time was 86.9 ± 36.9 (30-180) min in group A and 117.9 ± 43.4 (40-220) min in group B (p = 0.0006). No conversion to open surgery nor bile duct injuries were observed in either group. CONCLUSIONS LC with NIR-ICG fluorescent cholangiography is safe and effective for early recognition of anatomical landmarks, reducing operative time as compared to LC with IOC, even when residents were the main operator. NIR-ICG fluorescent cholangiography was effective in patients with acute cholecystitis and in the obese. Data collection into large registries on the results of NIR-ICG fluorescent cholangiography during LC should be encouraged to establish whether this technique might set a new safety standard for LC.

中文翻译：

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腹腔镜胆囊切除术中常规近红外吲哚菁绿荧光胆管造影术与术中胆管造影术的病例对照比较。

背景技术目的是评估腹腔镜胆囊切除术（LC）（A组）期间近红外（NIR）吲哚菁绿（ICG）荧光结构成像的安全性和有效性，并与一系列患者比较围手术期数据，包括手术时间行常规传统术中胆道造影（IOC）的LC患者（B组）。方法对44例急性或慢性胆囊炎患者在LC期间进行了NIR-ICG荧光胆管造影。在手术期间以不同的时间间隔静脉内给予ICG或直接胆囊注射。根据视觉模拟量表（介于1（最不准确）和5（最准确）之间）对荧光强度和解剖结构鉴定进行评分。B组患者（n = 44）选自前瞻性维护的接受常规IOC LC治疗的患者，其年龄，性别，体重指数和A组患者的诊断均相匹配。结果未发现不良反应。在A组中，ICG静脉给药与手术之间的平均时间为10.7±8.2小时（范围2-52）。施用剂量为3.5至13.5mg。所有病例均存在荧光，在41例患者中得分≥3。A组的平均手术时间为86.9±36.9（30-180）分钟，B组的平均手术时间为117.9±43.4（40-220）分钟（p = 0.0006）。两组均未观察到开放手术或胆管损伤。结论LC与NIR-ICG荧光胆管造影术相比可安全，有效地及早识别解剖标志，与IOC LC相比，可减少手术时间，即使居民是主要经营者。NIR-ICG荧光胆管造影对急性胆囊炎和肥胖症患者有效。应鼓励在LC期间将大量的NIR-ICG荧光胆管造影结果收集到大型注册表中，以确定该技术是否可以为LC设定新的安全标准。