The outcome of real-time evaluation of biliary flow using near-infrared fluorescence cholangiography with Indocyanine green in biliary atresia surgery

Yusuke Yanagi, Koichiro Yoshimaru, Toshiharu Matsuura, Yuichi Shibui, Kenichi Kohashi, Yoshiaki Takahashi, Satoshi Obata, Ryota Sozaki, Tomoko Izaki, Tomoaki Taguchi

Research output: Contribution to journalArticle

Abstract

Background: Indocyanine green (ICG) fluorescence imaging is a promising tool for intraoperative decision-making. The aim of this study was to evaluate the utility of near-infrared fluorescence cholangiography (NIR-FCG) with ICG in primary surgery for biliary atresia (BA). Methods: We performed NIR-FCG with ICG in 10 BA patients and observed the fluorescence of their hilar micro-bile ducts and hilar exudate in order to assess the appropriate level at which to dissect the hilar fibrous corn. We compared the jaundice outcome of 10 patients using NIR-FCG (Group A) to that of 35 historical patients in whom NIR-FCG had not been used (Group B). Results: The mean age of patients was 74.8 days. The classification of BA was type I in two cases and type-III in eight cases. NIR-FCG visualized the hilar micro-bile ducts, and the incidence of positive fluorescence was 80%. The ratio of postoperative normalization of hyperbilirubinemia in Group A was significantly higher than that in Group B (1.0 vs. 0.65, p < 0.05). Conclusion: NIR-FCG provided important objectifiable information about the biliary structures in surgery of BA. Although the number of cases was small, our results suggest that NIR-FCG may be useful for improving the outcome of primary surgery for BA. Type of Study: Study of Diagnostic Test. Level of Evidence: Level III.

Original languageEnglish
Pages (from-to)2574-2578
Number of pages5
JournalJournal of Pediatric Surgery
Volume54
Issue number12
DOIs
Publication statusPublished - Dec 2019

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Biliary Atresia
Indocyanine Green
Cholangiography
Fluorescence
Bile Ducts
Hyperbilirubinemia
Optical Imaging
Exudates and Transudates
Jaundice
Routine Diagnostic Tests
Zea mays
Decision Making

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pediatrics, Perinatology, and Child Health

Cite this

@article{c40660601e044bb39539572e68276a8c,
title = "The outcome of real-time evaluation of biliary flow using near-infrared fluorescence cholangiography with Indocyanine green in biliary atresia surgery",
abstract = "Background: Indocyanine green (ICG) fluorescence imaging is a promising tool for intraoperative decision-making. The aim of this study was to evaluate the utility of near-infrared fluorescence cholangiography (NIR-FCG) with ICG in primary surgery for biliary atresia (BA). Methods: We performed NIR-FCG with ICG in 10 BA patients and observed the fluorescence of their hilar micro-bile ducts and hilar exudate in order to assess the appropriate level at which to dissect the hilar fibrous corn. We compared the jaundice outcome of 10 patients using NIR-FCG (Group A) to that of 35 historical patients in whom NIR-FCG had not been used (Group B). Results: The mean age of patients was 74.8 days. The classification of BA was type I in two cases and type-III in eight cases. NIR-FCG visualized the hilar micro-bile ducts, and the incidence of positive fluorescence was 80{\%}. The ratio of postoperative normalization of hyperbilirubinemia in Group A was significantly higher than that in Group B (1.0 vs. 0.65, p < 0.05). Conclusion: NIR-FCG provided important objectifiable information about the biliary structures in surgery of BA. Although the number of cases was small, our results suggest that NIR-FCG may be useful for improving the outcome of primary surgery for BA. Type of Study: Study of Diagnostic Test. Level of Evidence: Level III.",
author = "Yusuke Yanagi and Koichiro Yoshimaru and Toshiharu Matsuura and Yuichi Shibui and Kenichi Kohashi and Yoshiaki Takahashi and Satoshi Obata and Ryota Sozaki and Tomoko Izaki and Tomoaki Taguchi",
year = "2019",
month = "12",
doi = "10.1016/j.jpedsurg.2019.08.029",
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TY - JOUR

T1 - The outcome of real-time evaluation of biliary flow using near-infrared fluorescence cholangiography with Indocyanine green in biliary atresia surgery

AU - Yanagi, Yusuke

AU - Yoshimaru, Koichiro

AU - Matsuura, Toshiharu

AU - Shibui, Yuichi

AU - Kohashi, Kenichi

AU - Takahashi, Yoshiaki

AU - Obata, Satoshi

AU - Sozaki, Ryota

AU - Izaki, Tomoko

AU - Taguchi, Tomoaki

PY - 2019/12

Y1 - 2019/12

N2 - Background: Indocyanine green (ICG) fluorescence imaging is a promising tool for intraoperative decision-making. The aim of this study was to evaluate the utility of near-infrared fluorescence cholangiography (NIR-FCG) with ICG in primary surgery for biliary atresia (BA). Methods: We performed NIR-FCG with ICG in 10 BA patients and observed the fluorescence of their hilar micro-bile ducts and hilar exudate in order to assess the appropriate level at which to dissect the hilar fibrous corn. We compared the jaundice outcome of 10 patients using NIR-FCG (Group A) to that of 35 historical patients in whom NIR-FCG had not been used (Group B). Results: The mean age of patients was 74.8 days. The classification of BA was type I in two cases and type-III in eight cases. NIR-FCG visualized the hilar micro-bile ducts, and the incidence of positive fluorescence was 80%. The ratio of postoperative normalization of hyperbilirubinemia in Group A was significantly higher than that in Group B (1.0 vs. 0.65, p < 0.05). Conclusion: NIR-FCG provided important objectifiable information about the biliary structures in surgery of BA. Although the number of cases was small, our results suggest that NIR-FCG may be useful for improving the outcome of primary surgery for BA. Type of Study: Study of Diagnostic Test. Level of Evidence: Level III.

AB - Background: Indocyanine green (ICG) fluorescence imaging is a promising tool for intraoperative decision-making. The aim of this study was to evaluate the utility of near-infrared fluorescence cholangiography (NIR-FCG) with ICG in primary surgery for biliary atresia (BA). Methods: We performed NIR-FCG with ICG in 10 BA patients and observed the fluorescence of their hilar micro-bile ducts and hilar exudate in order to assess the appropriate level at which to dissect the hilar fibrous corn. We compared the jaundice outcome of 10 patients using NIR-FCG (Group A) to that of 35 historical patients in whom NIR-FCG had not been used (Group B). Results: The mean age of patients was 74.8 days. The classification of BA was type I in two cases and type-III in eight cases. NIR-FCG visualized the hilar micro-bile ducts, and the incidence of positive fluorescence was 80%. The ratio of postoperative normalization of hyperbilirubinemia in Group A was significantly higher than that in Group B (1.0 vs. 0.65, p < 0.05). Conclusion: NIR-FCG provided important objectifiable information about the biliary structures in surgery of BA. Although the number of cases was small, our results suggest that NIR-FCG may be useful for improving the outcome of primary surgery for BA. Type of Study: Study of Diagnostic Test. Level of Evidence: Level III.

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