Direct gallbladder Indocyanine Green injection technique to achieve critical view of safety in laparoscopic cholecystectomy

Introduction: Bile duct injury is one of the most severe complications after cholecystectomy. The aim of this study is to demonstrate how with a simple technique, an optimal critical view may be achieved by injecting indocyanine green directly into the gallbladder. Methods: Twenty-three patients were prospectively studied in which direct gallbladder injection of indocyanine green during laparoscopy was administered with a fine needle using an easily reproducible technique. Results: Biliary tree identification was reported before and after injection. Critical view of safety was achieved in all cases. Conclusions: Our technique of direct gallbladder injection of indocyanine green is simple, efficient and shows a real time fluorescent cholangiography and an optimal critical view of safety decreasing the risk for bile duct injury. (C) 2021 AEC. Published by Elsevier Espana, S.L.U. All rights reserved.