Our Summary

This research paper is about a study looking into the use of a visualization technique, called indocyanine green fluorescent cholangiography, during laparoscopic cholecystectomy - a minimally invasive surgery to remove the gallbladder. The goal of the technique is to help surgeons better see and understand the biliary anatomy (the network of ducts and canals in the liver that create and transport bile) to prevent mistakes during surgery.

The researchers collected data from multiple studies involving a total of 1,586 patients up to August 2024. They looked at how well this technique could identify different parts of the biliary system, and if it could help to reduce the number of bile duct injuries.

The results showed that the technique didn’t make a significant difference in preventing bile duct injuries or in identifying certain parts of the biliary system. However, it did significantly improve the ability to identify the common bile duct, a major part of the biliary system.

The researchers concluded that this technique can help surgeons better identify the common bile duct during gallbladder removal surgeries. However, more research is needed to confirm if this technique can help identify other parts of the biliary system and improve the overall outcome for patients.

FAQs

  1. What is the purpose of using the indocyanine green fluorescent cholangiography technique during laparoscopic cholecystectomy?
  2. What were the key findings of the research regarding the use of this technique in identifying parts of the biliary system?
  3. According to the research, does the technique significantly reduce bile duct injuries during laparoscopic cholecystectomy?

Doctor’s Tip

A helpful tip a doctor might tell a patient about laparoscopic cholecystectomy is to ask about the use of indocyanine green fluorescent cholangiography during the surgery. This visualization technique can help the surgeon better identify the common bile duct and potentially reduce the risk of bile duct injuries. It’s important to discuss this option with your surgeon to see if it may be beneficial for your specific case.

Suitable For

Patients who are typically recommended for laparoscopic cholecystectomy include those with symptomatic gallstones, gallbladder polyps, biliary dyskinesia, acute cholecystitis, chronic cholecystitis, and other gallbladder-related conditions. Additionally, patients who are at higher risk for complications from traditional open surgery, such as older adults, those with multiple comorbidities, or those who are obese, may also be good candidates for laparoscopic cholecystectomy.

Timeline

Before laparoscopic cholecystectomy:

  1. Patient experiences symptoms of gallbladder disease such as abdominal pain, nausea, and vomiting.
  2. Patient undergoes diagnostic tests such as ultrasound or CT scan to confirm the presence of gallstones.
  3. Surgeon recommends laparoscopic cholecystectomy as the treatment option.
  4. Patient undergoes pre-operative evaluation and preparation for surgery.

During laparoscopic cholecystectomy:

  1. Patient is placed under general anesthesia.
  2. Surgeon makes small incisions in the abdomen and inserts a laparoscope to view the gallbladder.
  3. Gallbladder is carefully dissected and removed from the body using specialized instruments.
  4. Surgeon may use indocyanine green fluorescent cholangiography to visualize the biliary system during surgery.

After laparoscopic cholecystectomy:

  1. Patient is monitored in the recovery room for any complications.
  2. Patient may experience some pain and discomfort at the incision sites.
  3. Patient is discharged from the hospital within a day or two after surgery.
  4. Patient is advised to follow post-operative care instructions and may need to make dietary changes.
  5. Patient follows up with the surgeon for a check-up to ensure proper healing and recovery.

What to Ask Your Doctor

  1. What is indocyanine green fluorescent cholangiography and how does it work?
  2. Why is this technique being recommended for my laparoscopic cholecystectomy surgery?
  3. How will this technique help the surgeon during the surgery?
  4. Are there any risks or potential complications associated with using this technique?
  5. What are the success rates of this technique in identifying different parts of the biliary system?
  6. Will the use of this technique affect the overall outcome of my surgery?
  7. Are there any alternative techniques that could be used instead of indocyanine green fluorescent cholangiography?
  8. How experienced is the surgeon in using this technique?
  9. How many cases has the surgeon performed using this technique and what were the outcomes?
  10. Are there any additional costs associated with using this technique during the surgery?

Reference

Authors: Pimentel T, Queiroz I, Gallo Ruelas M, Florêncio de Mesquita C, Defante MLR, Roy M, Loftus TJ. Journal: Surgery. 2025 May;181:109149. doi: 10.1016/j.surg.2025.109149. Epub 2025 Jan 31. PMID: 39891966