Intraoperative Laparoscopic Near-Infrared Fluorescence Cholangiography to Facilitate Anatomical Identification: When to Give Indocyanine Green and How Much

被引:50
作者
Zarrinpar, Ali [1 ]
Dutson, Erik P. [1 ]
Mobley, Constance [1 ]
Busuttil, Ronald W. [1 ]
Lewis, Catherine E. [1 ]
Tillou, Areti [1 ]
Cheaito, Ali [1 ]
Hines, O. Joe [1 ]
Agopian, Vatche G. [1 ]
Hiyama, Darryl T. [1 ]
机构
[1] Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA
关键词
infrared fluorescence; intraoperative cholangiography; biliary anatomy; intraoperative guidance; CHOLECYSTECTOMY;
D O I
10.1177/1553350616637671
中图分类号
R61 [外科手术学];
学科分类号
摘要
Recent technological advances have enabled real-time near-infrared fluorescence cholangiography (NIRFC) with indocyanine green (ICG). Whereas several studies have shown its feasibility, dosing and timing for practical use have not been optimized. We undertook a prospective study with systematic variation of dosing and timing from injection of ICG to visualization. Adult patients undergoing laparoscopic biliary and hepatic operations were enrolled. Intravenous ICG (0.02-0.25 mg/kg) was administered at times ranging from 10 to 180 minutes prior to planned visualization. The porta hepatis was examined using a dedicated laparoscopic system equipped to detect NIRFC. Quantitative analysis of intraoperative fluorescence was performed using a scoring system to identify biliary structures. A total of 37 patients were enrolled. Visualization of the extrahepatic biliary tract improved with increasing doses of ICG, with qualitative scores improving from 1.9 +/- 1.2 (out of 5) with a 0.02-mg/kg dose to 3.4 +/- 1.3 with a 0.25-mg/kg dose (P < .05 for 0.02 vs 0.25 mg/kg). Visualization was also significantly better with increased time after ICG administration (1.1 +/- 0.3 for 10 minutes vs 3.4 +/- 1.1 for 45 minutes, P < .01). Similarly, quantitative measures also improved with both dose and time. There were no complications from the administration of ICG. These results suggest that a dose of 0.25 mg/kg administered at least 45 minutes prior to visualization facilitates intraoperative anatomical identification. The dosage and timing of administration of ICG prior to intraoperative visualization are within a range where it can be administered in a practical, safe, and effective manner to allow intraoperative identification of extrahepatic biliary anatomy using NIRFC.
引用
收藏
页码:360 / 365
页数:6
相关论文
共 10 条
  • [1] BONASCH H, 1964, AM J VET RES, V25, P254
  • [2] Systematic review of intraoperative cholangiography in cholecystectomy
    Ford, J. A.
    Soop, M.
    Du, J.
    Loveday, B. P. T.
    Rodgers, M.
    [J]. BRITISH JOURNAL OF SURGERY, 2012, 99 (02) : 160 - 167
  • [3] HOCHHEIMER BF, 1971, ARCH OPHTHALMOL-CHIC, V86, P564
  • [4] Fluorescent cholangiography illuminating the biliary tree during laparoscopic cholecystectomy
    Ishizawa, T.
    Bandai, Y.
    Ijichi, M.
    Kaneko, J.
    Hasegawa, K.
    Kokudo, N.
    [J]. BRITISH JOURNAL OF SURGERY, 2010, 97 (09) : 1369 - 1377
  • [5] Ishizawa Takeaki, 2009, J Am Coll Surg, V208, pe1, DOI 10.1016/j.jamcollsurg.2008.09.024
  • [6] Near-infrared fluorescent cholangiography facilitates identification of biliary anatomy during laparoscopic cholecystectomy
    Osayi, Sylvester N.
    Wendling, Mark R.
    Drosdeck, Joseph M.
    Chaudhry, Umer I.
    Perry, Kyle A.
    Noria, Sabrena F.
    Mikami, Dean J.
    Needleman, Bradley J.
    Muscarella, Peter H.
    Abdel-Rasoul, Mahmoud
    Renton, David B.
    Melvin, W. Scott
    Hazey, Jeffrey W.
    Narula, Vimal K.
    [J]. SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, 2015, 29 (02): : 368 - 375
  • [7] Variation in the Use of Intraoperative Cholangiography During Cholecystectomy
    Sheffield, Kristin M.
    Han, Yimei
    Kuo, Yong-Fang
    Townsend, Courtney M., Jr.
    Goodwin, James S.
    Riall, Taylor S.
    [J]. JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS, 2012, 214 (04) : 668 - 679
  • [8] US Centers for Disease Control and Prevention, INP SURG
  • [9] Optimization of near-infrared fluorescence cholangiography for open and laparoscopic surgery
    Verbeek, Floris P. R.
    Schaafsma, Boudewijn E.
    Tummers, Quirijn R. J. G.
    van der Vorst, Joost R.
    van der Made, Wendeline J.
    Baeten, Coen I. M.
    Bonsing, Bert A.
    Frangioni, John V.
    van de Velde, Cornelis J. H.
    Vahrmeijer, Alexander L.
    Swijnenburg, Rutger-Jan
    [J]. SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, 2014, 28 (04): : 1076 - 1082
  • [10] Recommendations for Laparoscopic Liver Resection A Report From the Second International Consensus Conference Held in Morioka
    Wakabayashi, Go
    Cherqui, Daniel
    Geller, David A.
    Buell, Joseph E.
    Kaneko, Hironori
    Han, Ho Seong
    Asbun, Horacio
    O'Rourke, Nicholas
    Tanabe, Minoru
    Koffron, Alan J.
    Tsung, Allan
    Soubrane, Olivier
    Machado, Marcel Autran
    Gayet, Brice
    Troisi, Roberto I.
    Pessaux, Patrick
    Van Dam, Ronald M.
    Scatton, Olivier
    Abu Hilal, Mohammad
    Belli, Giulio
    Kwon, Choon Hyuck David
    Edwin, Bjorn
    Choi, Gi Hong
    Aldrighetti, Luca Antonio
    Cai, Xiujun
    Clemy, Sean
    Chen, Kuo-Hsin
    Schoen, Michael R.
    Sugioka, Atsushi
    Tang, Chung-Ngai
    Herman, Paulo
    Pekolj, Juan
    Chen, Xiao-Ping
    Dagher, Ibrahim
    Jarnagin, William
    Yamamoto, Masakazu
    Strong, Russell
    Jagannath, Palepu
    Lo, Chung-Mau
    Clavien, Pierre-Alain
    Kokudo, Norihiro
    Barkun, Jeffrey
    Strasberg, Steven M.
    [J]. ANNALS OF SURGERY, 2015, 261 (04) : 619 - 629