ArticleUpdates in surgery2025
Role of intraoperative indocyanine green roadmap as a safety measure in emergent laparoscopic cholecystectomy.
Article in Updates in surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Does ICG-NIRF cholangiography replace the critical view of safety in laparoscopic cholecystectomy? A prospective evaluation on biliary visualization dynamics and the impact of inflammation.Surgical endoscopy · 2026Article
- Laparoscopic management of a rare intrahepatic bile duct variation in a patient with cholelithiasis: a case report and review of the literature.BMC surgery · 2026Review
- Surgical outcomes of indocyanine green fluorescent cholangiography in emergency laparoscopic cholecystectomy performed by junior surgeons for acute cholecystitis.Frontiers in surgery · 2026Article
- Seeing beyond white light: fluorescence for safer laparoscopic cholecystectomy.Frontiers in surgery · 2026Review
- Acute cholecystitis: a new technique to use carefully.World journal of emergency surgery : WJES · 2025Article
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Acute cholecystitis is a growing pathology, with high surgical risk due to the related patients' comorbidity. The gold standard treatment is laparoscopic cholecystectomy, which, despite its high volume, still presents elevated rates of biliary tract injury. Standardization of the procedure and accurate identification of the anatomical structures of the biliary tree are the key in avoiding severe complications associated with this injury. Innovation in minimally invasive technologies, such as infrared indocyanine green as a radiotracer to delimit the biliary anatomy, could reduce the rate of biliary tract lesions. A single-center case-control study was conducted, including patients undergoing emergency surgery between November 2023 and November 2024 for acute cholecystitis (Tokyo Guidelines 2018 criteria). Eighty-seven patients were allocated into two groups: emergency laparoscopic cholecystectomy with or without intraoperative indocyanine green cholangiography. The primary aim was to evaluate ICG's impact on reducing bile duct injury. Secondary outcomes included operative time, hospital stay, and conversion rates. The mean operative time (93 min vs. 104.6 min, p = 0.087), ASA scale (p = 0.302) and Charlson comorbidity index (2.55 vs. 2.84; p = 0.58) were not significantly different when comparing both groups. The control group showed duplicated preoperative CRP values as compared to the ICG group (138.24 mg/l vs. 71.02 mg/l; p = 0.06), and a higher median hospital stay (5 days ± 3 vs. 3 days ± 1.75; p = 0.001). The control group showed a greater need for conversion to open surgery (14.3% vs. 0%; p = 0.015). Trends towards fewer bile duct injuries (0% vs. 4.1%; p = 0.208) and fewer complications (15.87% vs. 18.4%; p = 0.752) in the ICG group were not statistically significant. The use of ICG may reduce the need for conversion to open surgery and median hospital stay. However, its use has not been proven to reduce bile duct injury, postoperative complications, or operative time.
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