ArticleSurgical endoscopy2022
Efficacy of indocyanine green (ICG) fluorescent cholangiography to improve intra-operative visualization during laparoscopic cholecystectomy in pediatric patients: a comparative study between ICG-guided fluorescence and standard technique.
Article in Surgical endoscopy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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11 citing papers in PubMed, 28 citations in OpenAlex.
- Short-interval intravenous indocyanine green administration in pediatric laparoscopic cholecystectomy: a prospective evaluation of visualization and safety.Pediatric surgery international · 2025Observational
- Advances in Fluorescent Adjuncts in Pediatric Surgery: A Comprehensive Review of Applications of Indocyanine Green Across Surgical Specialties.Children (Basel, Switzerland) · 2025Review
- Laparoscopic cholecystectomy for duplication of the gallbladder: A case report.International journal of surgery case reports · 2025Article
- A preliminary study using luminol-enhanced intraoperative bile duct imaging technique in rabbits.Scientific reports · 2025Article
- Advancing Pediatric Surgery with Indocyanine Green (ICG) Fluorescence Imaging: A Comprehensive Review.Children (Basel, Switzerland) · 2025Review
- Practical Guidelines for the Use of Indocyanine Green in Different Branches of Pediatric Surgery: A Polish Nationwide Multi-Center Retrospective Cohort Study.Health science reports · 2025Article
- Fluorescence imaging-assisted thoracoscopic anatomical lesion resection in treating congenital lung malformation.Scientific reports · 2025Article
- Indocyanine green fluorescence improves safety in laparoscopic cholecystectomy using the Fundus First technique: a retrospective study.Frontiers in surgery · 2025Article
- Standardization of a goal-oriented approach to acute cholecystitis: easy-to-follow steps for performing subtotal cholecystectomy.Langenbeck's archives of surgery · 2024Article
- Identification of Pediatric Tumors Intraoperatively Using Indocyanine Green (ICG).Annals of surgical oncology · 2023Review
- Evaluating the Development Status of Fluorescence-Guided Surgery (FGS) in Pediatric Surgery Using the Idea, Development, Exploration, Assessment, and Long-Term Study (IDEAL) Framework.Children (Basel, Switzerland) · 2023Review
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Authors and funding
4 authors at 1 institution in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundIn the last few years, indocyanine green (ICG) fluorescent cholangiography (FC) has been adopted to perform intra-operative biliary mapping during laparoscopic cholecystectomy (LC). This study aimed to compare the results of LC with and without use of ICG-FC.
methodsAll LC operated from June 2017 to June 2021 in our unit were retrospectively reviewed. Pre-operative workup included ultrasonography to assess dilation of main biliary tree. The ICG dosage was 0.35 mg/kg and the median timing of administration was 15.5 h pre-operatively. We evaluated, analyzing videorecorded procedures, 3 parameters in both groups: the total operative time (T1), the time of cystic duct isolation, clipping and sectioning (T2), and the time of gallbladder removal from hepatic fossa (T3).
resultsForty-three LC were operated in the study period: 22 using standard technique (G1) and 21 using ICG-FC (G2). There were 27 girls and 16 boys, with median age at surgery of 11.5 years (range 7-17) and median weight of 47 kg (range 31-110). No conversions were reported in our series. In all ICG cases (except one patient under therapy with phenobarbital) the biliary tree was perfectly visualized during dissection. Intra-operative complications occurred in 3 G1 patients (13.6%): 2 bleedings from the Calot's triangle and 1 bleeding from the liver bed during the gallbladder removal. LC was significantly faster in G2 than in G1 (p = 0.001). In fact, the parameters analyzed (T1, T2, T3) were all significantly greater in G1 than in G2 (p = 0.001).
conclusionsBased upon our experience, we strongly recommend the use of ICG-FC in all pediatric patients undergoing LC. ICG-guided fluorescence provided an excellent real-time visualization of the extrahepatic biliary tree and allowed faster and safer dissection, minimizing the risk of bile duct injuries. Furthermore, ICG use was clinically safe, with no adverse reactions to the product.
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