Fluorescence-based cholangiography
Autor: | Alberto Arezzo, Lorenzo Casali, Alend Saadi, Michele Diana, Luigi Boni, Maurizio Castagnola, Andrea Picchetto, Alessandro M. Paganini, Luciano Tartamella, Silvia Quaresima, Haralds Plaudis, Caterina Santi, Antonio Pesce, Jacqueline van den Bos, Salvador Morales-Conde, Andrea Balla, Gaetano La Greca, Vincent Agnus, G. Moretto, Jacques Marescaux |
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Přispěvatelé: | Surgery, RS: NUTRIM - R2 - Liver and digestive health |
Jazyk: | angličtina |
Rok vydání: | 2020 |
Předmět: |
Male
Registry CHOLECYSTECTOMY genetic structures medicine.medical_treatment INDOCYANINE GREEN 030230 surgery Fluorescence NEAR-INFRARED-FLUORESCENCE 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Cholangiography Cholelithiasis GUIDED SURGERY medicine Cholecystitis Humans Image-guided surgery ROUTINE USE Registries Univariate analysis Common bile duct medicine.diagnostic_test business.industry Middle Aged medicine.disease Near-infrared fluorescence cholangiography eye diseases Europe medicine.anatomical_structure Common hepatic duct chemistry Surgery Computer-Assisted Multivariate Analysis Linear Models Cystic duct Fluorescence-guided surgery 030211 gastroenterology & hepatology Surgery Cholecystectomy Female Nuclear medicine business Indocyanine green |
Zdroj: | Surgical endoscopy and other interventional techniques, 34(9), 3888-3896. Springer, Cham |
ISSN: | 1432-2218 0930-2794 |
Popis: | Introduction Near-infrared fluorescence cholangiography (NIRF-C) is a popular application of fluorescence image-guided surgery (FIGS). NIRF-C requires near-infrared optimized laparoscopes and the injection of a fluorophore, most frequently Indocyanine Green (ICG), to highlight the biliary anatomy. It is investigated as a tool to increase safety during cholecystectomy. The European registry on FIGS (EURO-FIGS: ) aims to obtain a snapshot of the current practices of FIGS across Europe. Data on NIRF-C are presented. Methods EURO-FIGS is a secured online database which collects anonymized data on surgical procedures performed using FIGS. Data collected for NIRF-C include gender, age, Body Mass Index (BMI), pathology, NIR device, ICG dose, ICG timing of administration before intraoperative visualization, visualization (Y/N) of biliary structures such as the cystic duct (CD), the common bile duct (CBD), the CD-CBD junction, the common hepatic duct (CHD), Visualization scores, adverse reactions to ICG, operative time, and surgical complications. Results Fifteen surgeons (12 European surgical centers) uploaded 314 cases of NIRF-C during cholecystectomy (cholelithiasis n = 249, cholecystitis n = 58, polyps n = 7), using 4 different NIR devices. ICG doses (mg/kg) varied largely (mean 0.28 +/- 0.17, median 0.3, range: 0.02-0.62). Similarly, injection-to-visualization timing (minutes) varied largely (mean 217 +/- 357; median 57), ranging from 1 min (direct intragallbladder injection in 2 cases) to 3120 min (n = 2 cases). Visualization scores before dissection were significantly correlated, at univariate analysis, with ICG timing (all structures), ICG dose (CD-CBD), device (CD and CD-CBD), surgeon (CD and CD-CBD), and pathology (CD and CD-CBD). BMI was not correlated. At multivariate analysis, pathology and timing remained significant factors affecting the visualization scores of all three structures, whereas ICG dose remained correlated with HD visualization only. Conclusions The EURO-FIGS registry has confirmed a wide disparity in ICG dose and timing in NIRF-C. EURO-FIGS can represent a valuable tool to promote and monitor FIGS-related educational and consensus activities in Europe. |
Databáze: | OpenAIRE |
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