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Indocyanine Green Reinjection Technique for Use in Fluorescent Angiography Concomitant With Cholangiography During Laparoscopic Cholecystectomy

Kaneko, Junichi PhD, MD; Ishizawa, Takeaki PhD, MD; Masuda, Koichi MD; Kawaguchi, Yoshikuni MD; Aoki, Taku PhD, MD; Sakamoto, Yoshihiro PhD, MD; Hasegawa, Kiyoshi PhD, MD; Sugawara, Yasuhiko PhD, MD; Kokudo, Norihiro PhD, MD

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques: August 2012 - Volume 22 - Issue 4 - p 341–344
doi: 10.1097/SLE.0b013e3182570240
Original Articles
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Background: For safe laparoscopic cholecystectomy, surgeons must possess detailed knowledge of the anatomy of the bile duct and arterial system as seen through a laparoscope.

Study Design: We developed an indocyanine green (ICG) reinjection technique for use in fluorescent angiography. Here, we evaluated the efficacy of the ICG reinjection technique in fluorescent angiography in discriminating the arterial system with the concomitant use of fluorescent cholangiography.

Results: Twenty-eight patients were enrolled in the study. All patients underwent laparoscopic cholecystectomy without complication. After reinjection of ICG during surgery, fluorescence of the cystic artery was visualized in 25 patients (89%).

Conclusions: Fluorescent angiography using this ICG reinjection technique might enhance the safety of laparoscopic cholecystectomy.

Department of Surgery, Hepato-Biliary-Pancreatic Surgery Division, Graduate School of Medicine, University of Tokyo, Tokyo, Japan

Supplemental Digital Content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website, www.surgical-laparoscopy.com.

Supported by grants 21791271 (J.K.) and 23689060 (T.I.) from the Ministry of Education, Culture, Sports, Science and Technology of Japan, Takeda Science Foundation (T.I.), the Kanae Foundation for the Promotion of Medical Science (T.I.), and the Pancreas Research Foundation of Japan (T.I.).

The authors declare no conflicts of interest.

Reprints: Norihiro Kokudo, PhD, MD, Department of Surgery, Hepato-Biliary-Pancreatic Surgery Division, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan (e-mail: kokudo-2su@h.u-tokyo.ac.jp).

Received August 18, 2011

Accepted March 9, 2012

© 2012 Lippincott Williams & Wilkins, Inc.