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

Autor: Dip F; Hospital de Clínicas José de San Martín, Buenos Aires, Argentina., Aleman J; Hospital Centro Médico, Laparoscopic surgery, Guatemala., DeBoer E; University of Groningen, University Medical Center Groningen, Groningen, the Netherlands., Boni L; Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico di Milano, University of Milan, Milan, Italy., Bouvet M; University of California San Diego, San Diego, CA., Buchs N; University Hospitals of Geneva, Geneva, Switzerland., Carus T; Niels-Stensen-Kliniken, Elisabeth-Hospital, Thuine, Germany., Diana M; Research Institute against Digestive Cancer (IRCAD), Strasbourg, France., Elli EF; Mayo Clinic, Jacksonville, FL., Hutteman M; Leiden University Medical Center, Leiden, the Netherlands., Ishizawa T; Graduate School of Medicine, University of Tokyo, Tokyo, Japan., Kokudo N; National Center for Global Health and Medicine, Tokyo, Japan., Lo Menzo E; Cleveland Clinic Florida, Weston, FL., Ludwig K; Klinikum Suedstadt Rostock, Rostock, Germany., Phillips E; Cedars-Sinai Medical Center, Los Angeles, CA., Regimbeau JM; CHU Amiens-Picardie, Site Sud, Service de Chirurgie Digestive, Amiens, France., Rodriguez-Zentner H; Hospital Punta Pacífica, Panama, Panama., Roy MD; Cleveland Clinic Florida, Weston, FL., Schneider-Koriath S; Klinikum Suedstadt Rostock, Rostock, Germany., Schols RM; Maastricht University Medical Center, Maastricht, Netherlands., Sherwinter D; Maimonides Medical Center, Brooklyn, NY., Simpfendorfer C; Cleveland Clinic Florida, Weston, FL., Stassen L; Maastricht University Medical Center, Maastricht, Netherlands., Szomstein S; Cleveland Clinic Florida, Weston, FL., Vahrmeijer A; Leiden University Medical Center, Leiden, the Netherlands., Verbeek FPR; Leiden University Medical Center, Leiden, the Netherlands., Walsh M; Cleveland Clinic, Cleveland, OH., White KP; ScienceRight Research Consulting, London ON, Canada., Rosenthal RJ; Cleveland Clinic Florida, Weston, FL. Electronic address: rosentr@ccf.org.
Jazyk: angličtina
Zdroj: Surgery [Surgery] 2022 Dec; Vol. 172 (6S), pp. S21-S28.
DOI: 10.1016/j.surg.2022.07.012
Abstrakt: 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.
(Copyright © 2022 The Author(s). Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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