A control study of indocyanine green fluorescence imaging in bile duct reexploration_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 FANG Cheng ^1,2,3,4 , WANG Piao ^1,2,3 , SU Song ^1,2,3 , LI Bo ^1,2,3 , YANG Xiaoli ^1,2,3 , GAN Yu ^1,2,3 , PENG Fangyi ^1,2,3 , TIAN Jie ⁴

1. Department of General Surgery (Hepatobiliary Surgery), The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, P. R. China;
2. Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, Sichuan 646000, P. R. China;
3. Academician (Expert) Workstation of Sichuan Province, Luzhou, Sichuan 646000, P. R. China;
4. Key Laboratory of Molecular Imaging, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, P. R. China;

Corresponding author：

FANG Cheng, Email: 13808288878@163.com

Keywords：

cholelithiasis; reoperation; indocyanine green fluorescence imaging

DOI：

10.7507/1007-9424.202204051

Video：

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Objective To investigate the value of indocyanine green fluorescence imaging in common bile duct reexploration. Methods The clinical data of 32 patients who underwent open common bile duct reexploration in the Affiliated Hospital of Southwest Medical University from January 2018 to December 2020 were collected retrospectively. All patients divided into the control group (conventional exploration group, 20 patients) and the fluorescence imaging group (using indocyanine green fluorescence imaging, 12 patients) according to the operational manner. The intraoperative and postoperative results of two groups were analyzed. Results The operative time [(165.2±6.9) min vs. (130.8±5.5) min], the time to find extrahepatic bile duct [(43.9±3.8) min vs. (23.1±4.1) min] and the amount of bleeding [(207.7±7.7) mL vs. (127.5±15.3) mL] in the control group were longer or more than those in the fluorescence imaging group (P<0.05). The incidence of postoperative infection in the control group [7 cases (35.0%) vs. 0 cases (0.0%)] and the length of hospital stay [(10.8±2.8) d vs. (7.1±1.3) d] were higher or longer than those in the fluorescence imaging group (P<0.05). There were no significant difference between the two groups in the incidence of postoperative bile fistula [6 cases (30.0%) vs. 2 cases (16.7%)] and the incidence of residual stones [3 cases (15.0%) vs. 3 cases (25.0%), P＞0.05]. Conclusion Indocyanine green fluorescence imaging appears to be a feasible, expeditious, useful, and effective imaging method while performing reexploration.

Citation： FANG Cheng, WANG Piao, SU Song, LI Bo, YANG Xiaoli, GAN Yu, PENG Fangyi, TIAN Jie. A control study of indocyanine green fluorescence imaging in bile duct reexploration. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2022, 29(6): 711-715. doi: 10.7507/1007-9424.202204051 Copy

1.	Cappelli A, Mosconi C, Cucchetti A, et al. Outcomes following percutaneous treatment of biliary stones. HPB (Oxford). 2019, 21(8): 1057-1063.
2.	Huang Y, Feng Q, Wang K, et al. The safety and feasibility of laparoscopic common bile duct exploration for treatment patients with previous abdominal surgery. Sci Rep, 2017, 7(1): 15372. doi: 10.1038/s41598-017-15782-y.
3.	Wang Y, Bo X, Wang Y, et al. Laparoscopic surgery for choledocholithiasis concomitant with calculus of the left intrahepatic duct or abdominal adhesions. Surg Endosc, 2017, 31(11): 4780-4789.
4.	Zhu J, Du P, He J, et al. Laparoscopic common bile duct exploration for patients with a history of prior biliary surgery: a comparative study with an open approach. ANZ J Surg, 2021, 91(3): E98-E103. doi: 10.1111/ans.16529.
5.	Ido K, Isoda N, Kawamoto C, et al. Confirmation of a “safety zone” by intraoperative cholangiography during laparoscopic cholecystectomy. Surg Endosc, 1996, 10(8): 798-800.
6.	He P, Huang T, Fang C, et al. Identification of extrahepatic metastasis of hepatocellular carcinoma using indocyanine green fluorescence imaging. Photodiagnosis Photodyn Ther, 2019, 25: 417-420.
7.	Pesce A, Piccolo G, La Greca G, et al. Utility of fluorescent cholangiography during laparoscopic cholecystectomy: A systematic review. World J Gastroenterol, 2015, 21(25): 7877-7883.
8.	Dip FD, Asbun D, Rosales-Velderrain A, et al. Cost analysis and effectiveness comparing the routine use of intraoperative fluorescent cholangiography with fluoroscopic cholangiogram in patients undergoing laparoscopic cholecystectomy. Surg Endosc, 2014, 28(6): 1838-1843.
9.	Hu Z, Fang C, Li B, et al. First-in-human liver-tumour surgery guided by multispectral fluorescence imaging in the visible and near-infrared-Ⅰ/Ⅱ windows. Nat Biomed Eng, 2020, 4(3): 259-271.

1. Cappelli A, Mosconi C, Cucchetti A, et al. Outcomes following percutaneous treatment of biliary stones. HPB (Oxford). 2019, 21(8): 1057-1063.
2. Huang Y, Feng Q, Wang K, et al. The safety and feasibility of laparoscopic common bile duct exploration for treatment patients with previous abdominal surgery. Sci Rep, 2017, 7(1): 15372. doi: 10.1038/s41598-017-15782-y.
3. Wang Y, Bo X, Wang Y, et al. Laparoscopic surgery for choledocholithiasis concomitant with calculus of the left intrahepatic duct or abdominal adhesions. Surg Endosc, 2017, 31(11): 4780-4789.
4. Zhu J, Du P, He J, et al. Laparoscopic common bile duct exploration for patients with a history of prior biliary surgery: a comparative study with an open approach. ANZ J Surg, 2021, 91(3): E98-E103. doi: 10.1111/ans.16529.
5. Ido K, Isoda N, Kawamoto C, et al. Confirmation of a “safety zone” by intraoperative cholangiography during laparoscopic cholecystectomy. Surg Endosc, 1996, 10(8): 798-800.
6. He P, Huang T, Fang C, et al. Identification of extrahepatic metastasis of hepatocellular carcinoma using indocyanine green fluorescence imaging. Photodiagnosis Photodyn Ther, 2019, 25: 417-420.
7. Pesce A, Piccolo G, La Greca G, et al. Utility of fluorescent cholangiography during laparoscopic cholecystectomy: A systematic review. World J Gastroenterol, 2015, 21(25): 7877-7883.
8. Dip FD, Asbun D, Rosales-Velderrain A, et al. Cost analysis and effectiveness comparing the routine use of intraoperative fluorescent cholangiography with fluoroscopic cholangiogram in patients undergoing laparoscopic cholecystectomy. Surg Endosc, 2014, 28(6): 1838-1843.
9. Hu Z, Fang C, Li B, et al. First-in-human liver-tumour surgery guided by multispectral fluorescence imaging in the visible and near-infrared-Ⅰ/Ⅱ windows. Nat Biomed Eng, 2020, 4(3): 259-271.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

A control study of indocyanine green fluorescence imaging in bile duct reexploration

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