Usability of Intraoperative Fluorescence Imaging with Indocyanine Green During Laparoscopic Cholecystectomy After Percutaneous Transhepatic Gallbladder Drainage

Shohei Yoshiya, Ryosuke Minagawa, Keisuke Kamo, Meidai Kasai, Kenji Taketani, Takafumi Yukaya, Yasue Kimura, Tadashi Koga, Masanori Kai, Kiyoshi Kajiyama, Tomoharu Yoshizumi

研究成果: Contribution to journalArticle査読

4 被引用数 (Scopus)

抄録

Background: Patients with persistent symptoms of acute cholecystitis for >72 h who cannot undergo urgent laparoscopic cholecystectomy (LC) often undergo percutaneous transhepatic gallbladder drainage (PTGBD) and delayed LC. However, intraoperative near-infrared fluorescence with indocyanine green (ICG) has recently become available in various surgical settings. Therefore, we evaluated the usability of intraoperative fluorescence imaging with ICG for LC after PTGBD in patients with acute cholecystitis. Methods: The preoperative and postoperative clinical characteristics of patients who underwent LC after PTGBD were retrospectively analyzed. Results: In total, 130 patients were reviewed. Intraoperative ICG fluorescence imaging was used in 39 (30.0%) patients, and none developed adverse reactions. Patients with ICG fluorescence imaging had a significantly shorter operative time (129 ± 46 vs. 150 ± 56 min, p = 0.0455), markedly lower conversion rate (2.6% vs. 22.0%, p = 0.0017), and lower proportion of subtotal cholecystectomy (0.0% vs. 6.6%, p = 0.0359) than patients without ICG fluorescence imaging. Independent risk factors for conversion to laparotomy during LC after PTGBD were the performance of PTGBD after 48 h from onset (OR 3.52; 95% CI 1.11–12.21; p = 0.0322), an unremoved PTGBD tube on LC (4.48, 1.46–15.00, p = 0.0084), and surgery without ICG (8.00, 1.28–159.47, p = 0.0231). Conclusion: Intraoperative ICG fluorescence imaging produced better surgical outcomes without any adverse reactions. Early performance of PTGBD and intraoperative ICG fluorescence imaging can reduce the surgical difficulties in LC after PTGBD for acute cholecystitis.

本文言語英語
ページ(範囲)127-133
ページ数7
ジャーナルWorld journal of surgery
43
1
DOI
出版ステータス出版済み - 1 15 2019
外部発表はい

All Science Journal Classification (ASJC) codes

  • 外科

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