Application of Fluorescence Image Guided Cholangiography for Assessment of Biliary Anatomy in Patients with Acute Cholecystitis

Activity: Talk or presentation types › Oral presentation

Description

Bile duct injuries(BDI) remains one of the most threatening complications during laparoscopic cholecystectomy(LC). In patients with acute cholecystitis(AC) the risk of BDI may increase. Fluorescence Cholangiography(FC) is non-invasive method for a real-time visualization of biliary anatomy. The aim of this study is to evaluate effect of FC for detection of biliary anatomy in patients with AC.. Patients with AC were considered for LC using FC and included in study from 2020 till 2023. Patients were divided into two groups:Group1.mild AC; Group2.moderate AC. Fixed dose(12.5 mg) of Indocyanine green was administered intravenously 12 hours before the surgery. FC identification rate of the EXBD anatomy were scored both before and after the dissection according to Critical View of Safety principle. Adapted visualization scales were applied.. A total of 67 patients underwent LC with FC: 37 females(55%), 30 males(45 %). The mean age was 56 years, average BMI-29kg/m2. Mild AC was diagnosed in 42(63%) and moderate in 25(37%) patients. The visualization rate of the cystic duct(CD), common bile duct(CBD) and common hepatic duct(CHD) prior to dissection was 80%,61%,41% but after dissection it improved to 91%,80%,62%. The comparison of visualized EXBD before CVS dissection between the groups revealed: Group1.:                            CD-39(93%)                                           CBD-29(69%)                                            CHD-19(45%) Group2.:                           CD-14(56%,p=0.007)                                          CBD-12(48%,p=0.41)                                          CHD-8(32%,p=0.79). FC was considered to be helpful to detect CD in 39(58%),CBD in 39(58%), CHD in 27(40%) patients. Disturbed score showed that liver fluorescence didn't disturbed to detect EXBD in 60(90%), slightly in 4(6 %), heavily in 2(3%) patients. Correlation between operative time and Likert scale showed statistically significant and moderate correlation (CD:r=-0.534,p
Period29 Mar 2023
Event titleRSU International Research Conference 2023: Knowledge for Use in Practice
Event typeConference
OrganiserRīga Stradiņš University
LocationRiga, LatviaShow on map
Degree of RecognitionInternational

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