Real-Time Fluorescent Cholangiography by Intrabiliary Indocyanine Green Administration With Near-Infrared Laparoscopy in Major Hepatectomy

Background and purpose: Biliary injury is a severe complication that can be associated with liver surgery. Intrahepatic biliary anatomy evaluated using magnetic resonance cholangiopancreatography X-ray cholangiography; however, an intraoperative real-time bile duct visualization method has not yet been reported. This study aimed to demonstrate the availability of fluorescent cholangiography (FC) by intrabiliary indocyanine green administration near-infrared laparoscopy in major hepatectomy. Methods: The optimal concentration (ICG) solution was examined ex vivo. fluorescence intensity ICG its mixture measured. Using clinical trial model, injected into cystic duct, followed performed during Results: for FC between 0.01 0.05 mg/mL. Three different laparoscopic systems were used three hepatectomy cases. In all cases, intrahepatic ducts Glissonian sheath clearly visualized system. A small piece tissue prevented glow; thus, exposure necessary clear FC. procedure also detected leakage from cut surface liver. Conclusions: Intrabiliary enabled