INDOCYANINE GREEN GUIDED LAPAROSCOPIC EXPLORATION OF COMMON BILE DUCT;VALUE AND EFFECTIVENESS

Abstract

Background: In recent years, the use of laparoscopic CBD exploration in the treatment of CBD stones has become more widespread. The bile duct must be extensively dissected during the transcystic and transductal exploration, which increases the risk of iatrogenic damage. In order to execute a real-time fluorescence cholangiography, indocyanine green (ICG) injection permits accurate identification of the biliary anatomy that may facilitate the process. Aim and Objectives: The purpose of this study is to assess the effectiveness, safety, and results of utilizing indocyanin green during laparascopic exploration of the common bile duct. Subjects and methods: The study is carried out in the department of General surgery, Minia university hospital during the period from 2022 to 2023. Our study will be prospective and retrospective and include 20 patients presented with CBD stones who will undergo laparoscopic CBD exploration using the ICG dye. Result: There was a great success in the difficult cases especially those with previous operations as the ICG dye makes better delineation of the anatomy of the biliary tract and hence safe dissection and short operative duration. The rate of cases converted to open also decreased in our study after usage of the indocyanin green dye. Conclusion: ICG injection results in exceptional biliary structures fluorescence, delineating biliary anatomy especially when there are adhesions or abnormal structure, it may be a useful tool in CBD exploration since it contrasts well with the hepatic parenchyma.