Use of a fluorescent bile acid to enhance visualization of the biliary tract and bile leaks during laparoscopic surgery in rabbits.
BACKGROUND
We set out to determine whether intravenously administered cholylglycylaminofluorescein (CGF), a fluorescent bile acid, would enhance the visualization of the biliary tract and bile leaks in rabbits undergoing laparoscopic cholecystectomy (LC).


METHODS
CGF was infused at doses of 1, 5, and 10 mg/kg b.w. Biliary recovery was determined spectrophotometrically (six rabbits). For LC (seven rabbits), a blue (fluorescein) filter was attached to the light source, and a fluorescein-emission filter was attached to the charge coupled device (CCD) camera. The biliary tract and bile leak (made by incising the gallbladder) was observed under standard and fluorescent illumination.


RESULTS
Apple-green fluorescence appeared in 2 min and persisted for 30-60 min, enhancing visualization of bile duct anatomy as well as the bile leak. Biliary recovery of CGF at 90 min was high (86-96% of the infused dose).


CONCLUSIONS
In rabbits, CGF is secreted quantitatively in bile, induces biliary fluorescence, and enhances visualization of the bile ducts and bile leaks when viewed with appropriate filters.
Holzinger
F
F
Department of Visceral and Transplantation Surgery, Inselspital, University of Bern, Murtenstrasse 35, CH-3010 Bern, Switzerland.
Krähenbühl
L
L
Schteingart
C D
CD
Ton-Nu
H T
HT
Hofmann
A F
AF
D000818:Animals; D001660:Biliary Tract Diseases / Q000175:diagnosis* / Q000601:surgery; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D002764:Cholecystitis / Q000175:diagnosis* / Q000601:surgery; D003287:Contrast Media; D004195:Disease Models, Animal; D005452:Fluoresceins; D007089:Image Enhancement / Q000379:methods*; D007275:Injections, Intravenous; D016343:Monitoring, Intraoperative / Q000379:methods*; D011817:Rabbits; D012680:Sensitivity and Specificity
D003287:Contrast Media; D005452:Fluoresceins; C090312:cholylglycylamidofluorescein