Application of fluorescence image guided cholangiography for the assessment of biliary anatomy in patients with acute cholecystitis

Jānis Pāvulāns; Maksims Mukāns; Haralds Plaudis

doi:10.1016/j.hpb.2024.03.167

Abstract

Introduction: Difficult laparoscopic cholecystectomy(DLC) is associated with increased risk of iatrogenic bile duct injury(IBDI). Fluorescence cholangiography(FC) is a visualization tool that helps to identify EHBD. The aim of the study is to assess the effect of FC for identification of EHBD in patients with acute cholecystitis(AC).
Method: Patients with AC who were scheduled for emergency LC using FC were prospectively included in study. The patients were divided into two groups: Group 1 mild AC; Group 2 moderate AC. 12.5 mg of Indocyanine green(ICG) was injected intravenously 12 hours before the surgery. FC and EHBD visualization rate were evaluated both before and after the dissection according to the Critical View of Safety(CVS) principle.
Results: In total, 94 patients were included. Among those 38% were males and 62% females. The median age was 56 years (range 18-86). 61 patients were included in Group 1, 33 patients in Group 2. FC visualization rate of cystic duct(CD), common bile duct(CBD) and common hepatic duct(CHD) were different between the groups (Table 1).
Group1. mild ACGroup2. moderate ACP value comparing to both groups
Before CVSCD-87% (n-53)CD-48% (n-16)p=< 0.001
CBD-72% (n-44)CBD-42% (n-14)p=0.04
CHD-49% (n-30)CHD-27% (n-9)p=0.19
After CVSCD-90% (n-55)CD-67% (n-22)p=0.01
CBD-84% (n-51)CBD-64% (n-21)p=0.03
CHD-72% (n-44)CHD-36% (n-12)p=0.07
ODB-011 - Table 1.
Open table in a new tab
All steps (8 of 8) of CVS were completed in 64%(Group 1) and 33%(Group 2) of the patients, p=<0.001. Lower BMI was associated with shorter OT(r=0.292, p=0.005) and higher rate for completion of CVS principle(r=0.287, p=0.006).
The mean OT was 67 (30-150) minutes and mean hospital stay was 6 (SD-3) days. No postoperative complications and IBDI were observed.
Conclusions: FC is safe, useful and effective method for visualization of EHBD that may help to reduce the risk of IBDI even in DLC.

Original language	English
DOIs	https://doi.org/10.1016/j.hpb.2024.03.167
Publication status	Published - Jan 2024
Event	16th World Congress of the International Hepato-Pancreato-Biliary Association - Cape Town, South Africa Duration: 15 May 2024 → 18 May 2024 Conference number: 16 https://www.ihpba.org/19_World-Congress.html

Congress

Congress	16th World Congress of the International Hepato-Pancreato-Biliary Association
Country/Territory	South Africa
City	Cape Town
Period	15/05/24 → 18/05/24
Internet address	https://www.ihpba.org/19_World-Congress.html

Field of Science*

3.2 Clinical medicine

Publication Type*

3.4. Other publications in conference proceedings (including local)

Access to Document

10.1016/j.hpb.2024.03.167

APPLICATION OF FLUORESCENCEFinal published version, 49.1 KB

Cite this

@conference{a25565eb6681400198ed69edd2570be6,

title = "Application of fluorescence image guided cholangiography for the assessment of biliary anatomy in patients with acute cholecystitis",

abstract = "Introduction: Difficult laparoscopic cholecystectomy(DLC) is associated with increased risk of iatrogenic bile duct injury(IBDI). Fluorescence cholangiography(FC) is a visualization tool that helps to identify EHBD. The aim of the study is to assess the effect of FC for identification of EHBD in patients with acute cholecystitis(AC). Method: Patients with AC who were scheduled for emergency LC using FC were prospectively included in study. The patients were divided into two groups: Group 1 mild AC; Group 2 moderate AC. 12.5 mg of Indocyanine green(ICG) was injected intravenously 12 hours before the surgery. FC and EHBD visualization rate were evaluated both before and after the dissection according to the Critical View of Safety(CVS) principle. Results: In total, 94 patients were included. Among those 38\% were males and 62\% females. The median age was 56 years (range 18-86). 61 patients were included in Group 1, 33 patients in Group 2. FC visualization rate of cystic duct(CD), common bile duct(CBD) and common hepatic duct(CHD) were different between the groups (Table 1). Group1. mild ACGroup2. moderate ACP value comparing to both groups Before CVSCD-87\% (n-53)CD-48\% (n-16)p=< 0.001 CBD-72\% (n-44)CBD-42\% (n-14)p=0.04 CHD-49\% (n-30)CHD-27\% (n-9)p=0.19 After CVSCD-90\% (n-55)CD-67\% (n-22)p=0.01 CBD-84\% (n-51)CBD-64\% (n-21)p=0.03 CHD-72\% (n-44)CHD-36\% (n-12)p=0.07 ODB-011 - Table 1. Open table in a new tab All steps (8 of 8) of CVS were completed in 64\%(Group 1) and 33\%(Group 2) of the patients, p=<0.001. Lower BMI was associated with shorter OT(r=0.292, p=0.005) and higher rate for completion of CVS principle(r=0.287, p=0.006). The mean OT was 67 (30-150) minutes and mean hospital stay was 6 (SD-3) days. No postoperative complications and IBDI were observed. Conclusions: FC is safe, useful and effective method for visualization of EHBD that may help to reduce the risk of IBDI even in DLC.",

author = "Jānis Pāvulāns and Maksims Mukāns and Haralds Plaudis",

year = "2024",

month = jan,

doi = "10.1016/j.hpb.2024.03.167",

language = "English",

note = "16th World Congress of the International Hepato-Pancreato-Biliary Association ; Conference date: 15-05-2024 Through 18-05-2024",

url = "https://www.ihpba.org/19\_World-Congress.html",

}

Application of fluorescence image guided cholangiography for the assessment of biliary anatomy in patients with acute cholecystitis. / Pāvulāns, Jānis ; Mukāns, Maksims ; Plaudis, Haralds.
2024. Abstract from 16th World Congress of the International Hepato-Pancreato-Biliary Association, Cape Town, South Africa.

Research output: Contribution to conference › Abstract

TY - CONF

T1 - Application of fluorescence image guided cholangiography for the assessment of biliary anatomy in patients with acute cholecystitis

AU - Pāvulāns, Jānis

AU - Mukāns, Maksims

AU - Plaudis, Haralds

N1 - Conference code: 16

PY - 2024/1

Y1 - 2024/1

N2 - Introduction: Difficult laparoscopic cholecystectomy(DLC) is associated with increased risk of iatrogenic bile duct injury(IBDI). Fluorescence cholangiography(FC) is a visualization tool that helps to identify EHBD. The aim of the study is to assess the effect of FC for identification of EHBD in patients with acute cholecystitis(AC). Method: Patients with AC who were scheduled for emergency LC using FC were prospectively included in study. The patients were divided into two groups: Group 1 mild AC; Group 2 moderate AC. 12.5 mg of Indocyanine green(ICG) was injected intravenously 12 hours before the surgery. FC and EHBD visualization rate were evaluated both before and after the dissection according to the Critical View of Safety(CVS) principle. Results: In total, 94 patients were included. Among those 38% were males and 62% females. The median age was 56 years (range 18-86). 61 patients were included in Group 1, 33 patients in Group 2. FC visualization rate of cystic duct(CD), common bile duct(CBD) and common hepatic duct(CHD) were different between the groups (Table 1). Group1. mild ACGroup2. moderate ACP value comparing to both groups Before CVSCD-87% (n-53)CD-48% (n-16)p=< 0.001 CBD-72% (n-44)CBD-42% (n-14)p=0.04 CHD-49% (n-30)CHD-27% (n-9)p=0.19 After CVSCD-90% (n-55)CD-67% (n-22)p=0.01 CBD-84% (n-51)CBD-64% (n-21)p=0.03 CHD-72% (n-44)CHD-36% (n-12)p=0.07 ODB-011 - Table 1. Open table in a new tab All steps (8 of 8) of CVS were completed in 64%(Group 1) and 33%(Group 2) of the patients, p=<0.001. Lower BMI was associated with shorter OT(r=0.292, p=0.005) and higher rate for completion of CVS principle(r=0.287, p=0.006). The mean OT was 67 (30-150) minutes and mean hospital stay was 6 (SD-3) days. No postoperative complications and IBDI were observed. Conclusions: FC is safe, useful and effective method for visualization of EHBD that may help to reduce the risk of IBDI even in DLC.

AB - Introduction: Difficult laparoscopic cholecystectomy(DLC) is associated with increased risk of iatrogenic bile duct injury(IBDI). Fluorescence cholangiography(FC) is a visualization tool that helps to identify EHBD. The aim of the study is to assess the effect of FC for identification of EHBD in patients with acute cholecystitis(AC). Method: Patients with AC who were scheduled for emergency LC using FC were prospectively included in study. The patients were divided into two groups: Group 1 mild AC; Group 2 moderate AC. 12.5 mg of Indocyanine green(ICG) was injected intravenously 12 hours before the surgery. FC and EHBD visualization rate were evaluated both before and after the dissection according to the Critical View of Safety(CVS) principle. Results: In total, 94 patients were included. Among those 38% were males and 62% females. The median age was 56 years (range 18-86). 61 patients were included in Group 1, 33 patients in Group 2. FC visualization rate of cystic duct(CD), common bile duct(CBD) and common hepatic duct(CHD) were different between the groups (Table 1). Group1. mild ACGroup2. moderate ACP value comparing to both groups Before CVSCD-87% (n-53)CD-48% (n-16)p=< 0.001 CBD-72% (n-44)CBD-42% (n-14)p=0.04 CHD-49% (n-30)CHD-27% (n-9)p=0.19 After CVSCD-90% (n-55)CD-67% (n-22)p=0.01 CBD-84% (n-51)CBD-64% (n-21)p=0.03 CHD-72% (n-44)CHD-36% (n-12)p=0.07 ODB-011 - Table 1. Open table in a new tab All steps (8 of 8) of CVS were completed in 64%(Group 1) and 33%(Group 2) of the patients, p=<0.001. Lower BMI was associated with shorter OT(r=0.292, p=0.005) and higher rate for completion of CVS principle(r=0.287, p=0.006). The mean OT was 67 (30-150) minutes and mean hospital stay was 6 (SD-3) days. No postoperative complications and IBDI were observed. Conclusions: FC is safe, useful and effective method for visualization of EHBD that may help to reduce the risk of IBDI even in DLC.

UR - https://www.hpbonline.org/action/showPdf?pii=S1365-182X%2824%2900224-7

U2 - 10.1016/j.hpb.2024.03.167

DO - 10.1016/j.hpb.2024.03.167

M3 - Abstract

T2 - 16th World Congress of the International Hepato-Pancreato-Biliary Association

Y2 - 15 May 2024 through 18 May 2024

ER -