Experience of indocyanine green use in acute calculous cholecystitis
12.03.2026
© A.E. KLIMOV, A.M. LEONOVICH, M.V. KOSACHENKO, A.A. BARKHUDAROV
Peoples’ Friendship University of Russia named after Patrice Lumumba, Moscow, Russia; City Clinical Hospital named after V.V. Vinogradov, Moscow, Russia
Abstract
Objective. To assess the safety and effectiveness of the indocyanine green use in acute cholecystitis for identification of anatomical variants of the biliary tree; prevention and timely detection of intraoperative complications.
Material and methods. The medication of indocyanine green made by OOO «Ferment» domestic manufacturer was used. The drug dose from 2.5 mg to 10 mg was applied according to studied materials (8). Time of the surgery beginning was from 2 to 6 hours after intravenous injection of aqueous solution, respectively. In addition, it has been established that the optimal drug dose is 5 mg. The surgery should be performed not earlier than 3 hours, but not later than 6 hours after administration of the drug. This allows achieving the most informative glow of the extrahepatic biliary tract. By this time, the drug concentration decreases in the liver cells and increases in the bile ducts. In emergency surgeries, it is not always possible to perform the operation strictly within the specified period, therefore, the above time interval was observed. Endoscopic equipment with the capability of fluorescence imaging in the near-infrared range was used. A laser light source with a wavelength of 820 nm as part of the 4K Stryker video system («Stryker Inc.», USA) was used to excite fluorescence, and an Olympus HD video system («Olympus Medical Systems Corp.», Japan) was also used.
Results. At the V.V. Vinogradov City Clinical Hospital (Moscow), 25 laparoscopic cholecystectomies using indocyanine green were performed. Patients included 6 (24%) men, 19 (76%) women, the average age was 63.5 years. The use of indocyanine green during cholecystectomy provided visualization of the topography and identification of anatomical variants of the biliary tree.
Conclusions. The introduction of intraoperative fluorescence navigation with indocyanine green contributes to increasing the safety and effectiveness of surgical treatment due to visualization of topography and identification of anatomical variants of the biliary tree, possibilities for prevention and timely detection of intraoperative complications. The use of indocyanine green allows intraoperative detection of atypical location and various variations of the extrahepatic bile ducts.
Peoples’ Friendship University of Russia named after Patrice Lumumba, Moscow, Russia; City Clinical Hospital named after V.V. Vinogradov, Moscow, Russia
Abstract
Objective. To assess the safety and effectiveness of the indocyanine green use in acute cholecystitis for identification of anatomical variants of the biliary tree; prevention and timely detection of intraoperative complications.
Material and methods. The medication of indocyanine green made by OOO «Ferment» domestic manufacturer was used. The drug dose from 2.5 mg to 10 mg was applied according to studied materials (8). Time of the surgery beginning was from 2 to 6 hours after intravenous injection of aqueous solution, respectively. In addition, it has been established that the optimal drug dose is 5 mg. The surgery should be performed not earlier than 3 hours, but not later than 6 hours after administration of the drug. This allows achieving the most informative glow of the extrahepatic biliary tract. By this time, the drug concentration decreases in the liver cells and increases in the bile ducts. In emergency surgeries, it is not always possible to perform the operation strictly within the specified period, therefore, the above time interval was observed. Endoscopic equipment with the capability of fluorescence imaging in the near-infrared range was used. A laser light source with a wavelength of 820 nm as part of the 4K Stryker video system («Stryker Inc.», USA) was used to excite fluorescence, and an Olympus HD video system («Olympus Medical Systems Corp.», Japan) was also used.
Results. At the V.V. Vinogradov City Clinical Hospital (Moscow), 25 laparoscopic cholecystectomies using indocyanine green were performed. Patients included 6 (24%) men, 19 (76%) women, the average age was 63.5 years. The use of indocyanine green during cholecystectomy provided visualization of the topography and identification of anatomical variants of the biliary tree.
Conclusions. The introduction of intraoperative fluorescence navigation with indocyanine green contributes to increasing the safety and effectiveness of surgical treatment due to visualization of topography and identification of anatomical variants of the biliary tree, possibilities for prevention and timely detection of intraoperative complications. The use of indocyanine green allows intraoperative detection of atypical location and various variations of the extrahepatic bile ducts.
