Fluorescence with intravesicular indocyanine green in laparoscopic cholecystectomy

Abstract

This research deals with a series of cases performed prospectively and observationally, to establish the efficacy of the use of intra gallbladder indocyanine green fluorescence in 15 patients undergoing laparoscopic cholecystectomy at the Chair of Clinical and Surgical Therapeutics A, Surgery Service I of the University Hospital of Caracas between June and August 2024. All patients were administered 2.5 mg of indocyanine green, the 25mg ampoule of indocyanine green Aldagor® was diluted in 10 ml of physiological saline solution, intravesicularly with a 25G spinal needle using an OptoMedic® FloNavi 214k laparoscopic tower. The technique was applied in a standardized way in all cases, before dissection of Calot's triangle.Results: Fluorescence was achieved in all cases, in the fundus and body of the gallbladder after intravesicular indocyanine green infiltration, fluorescence occurred at 2.4 minutes, the fluorescence time in the cystic duct was a mean of 3.8 minutes, and the fluorescence time in the common bile duct was a mean of 5.67 minutes. Conclusion: This technique provides superior visibility of the biliary anatomy in real time, which significantly reduces the risk of iatrogenic injury and improves surgical precision, especially in more complex cases where accurate identification of anatomical structures is crucial to avoid serious complications.