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Article Dans Une Revue Surgery Année : 2022

Use of fluorescence imaging and indocyanine green during laparoscopic cholecystectomy: Results of an international Delphi survey

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Fernando Dip
  • Fonction : Auteur
Julio Aleman
  • Fonction : Auteur
Esther Deboer
  • Fonction : Auteur
Luigi Boni
  • Fonction : Auteur
Michael Bouvet
Nicholas Buchs
  • Fonction : Auteur
Thomas Carus
  • Fonction : Auteur
Enrique Elli
  • Fonction : Auteur
Takeaki Ishizawa
  • Fonction : Auteur
Norihiro Kokudo
  • Fonction : Auteur
Emanuele Lo Menzo
Kaja Ludwig
  • Fonction : Auteur
Edward Phillips
  • Fonction : Auteur
Homero Rodriguez-Zentner
  • Fonction : Auteur
Mayank Dramani Roy
  • Fonction : Auteur
Sylke Schneider-Koriath
  • Fonction : Auteur
Rutger Schols
  • Fonction : Auteur
Danny Sherwinter
  • Fonction : Auteur
Conrad Simpfendorfer
  • Fonction : Auteur
Laurent Stassen
Samuel Szomstein
  • Fonction : Auteur
Alexander Vahrmeijer
  • Fonction : Auteur
Floris P.R. Verbeek
  • Fonction : Auteur
Matthew Walsh
  • Fonction : Auteur
Kevin White
  • Fonction : Auteur
Raul Rosenthal
  • Fonction : Auteur

Résumé

Background: Published empirical data have increasingly suggested that using near-infrared fluorescence cholangiography during laparoscopic cholecystectomy markedly increases biliary anatomy visualization. The technology is rapidly evolving, and different equipment and doses may be used. We aimed to identify areas of consensus and nonconsensus in the use of incisionless near-infrared fluorescent cholangiography during laparoscopic cholecystectomy. Methods: A 2-round Delphi survey was conducted among 28 international experts in minimally invasive surgery and near-infrared fluorescent cholangiography in 2020, during which respondents voted on 62 statements on patient preparation and contraindications (n = 12); on indocyanine green administration (n = 14); on potential advantages and uses of near-infrared fluorescent cholangiography (n = 18); comparing near-infrared fluorescent cholangiography with intraoperative x-ray cholangiography (n = 7); and on potential disadvantages of and required training for near-infrared fluorescent cholangiography (n = 11). Results: Expert consensus strongly supports near-infrared fluorescent cholangiography superiority over white light for the visualization of biliary structures and reduction of laparoscopic cholecystectomy risks. It also offers other advantages like enhancing anatomic visualization in obese patients and those with moderate to severe inflammation. Regarding indocyanine green administration, consensus was reached that dosing should be on a milligrams/kilogram basis, rather than as an absolute dose, and that doses >0.05 mg/kg are necessary. Although there is no consensus on the optimum preoperative timing of indocyanine green injections, the majority of participants consider it important to administer indocyanine green at least 45 minutes before the procedure to decrease the light intensity of the liver. Conclusion: Near-infrared fluorescent cholangiography experts strongly agree on its effectiveness and safety during laparoscopic cholecystectomy and that it should be used routinely, but further research is necessary to establish optimum timing and doses for indocyanine green.
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Dates et versions

hal-03881452 , version 1 (01-12-2022)

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Citer

Fernando Dip, Julio Aleman, Esther Deboer, Luigi Boni, Michael Bouvet, et al.. Use of fluorescence imaging and indocyanine green during laparoscopic cholecystectomy: Results of an international Delphi survey. Surgery, 2022, 172 (6), pp.S21-S28. ⟨10.1016/j.surg.2022.07.012⟩. ⟨hal-03881452⟩
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