title: Fluorescent imaging of the biliary tract during laparoscopic cholecystectomy.
abstract: The introduction of laparoscopic cholecystectomy was associated with increased incidences of bile duct injury. The primary cause appears to be misidentification of the biliary anatomy. Routine intra-operative cholangiography has been recommended to reduce accidental duct injury, although in practice it is more often reserved for selected cases. There has been interest in the use of fluorescent agents excreted via the biliary system to enable real-time intra-operative imaging, to aid the laparoscopic surgeon in correctly interpreting the anatomy. The primary aim of this review is to evaluate the ability of fluorescent cholangiography to identify important biliary anatomy intra-operatively. Secondary aims are to investigate its ability to detect important intra-operative pathology such as bile leaks, identify potential alternative fluorophores, and evaluate the evidence regarding patient outcomes.
authors.affiliation: UCL Division of Surgery & Interventional Science, 9th Floor, Royal Free Hospital, Pond Street, London NW3 2QG, United Kingdom.
authors.forename: Darren Leonard
authors.initials: DL
authors.lastname: Scroggie
authors.affiliation: Department of HPB Surgery, Mater Infirmorum Hospital, Crumlin Road, Belfast BT14 6AB, United Kingdom.
authors.forename: Claire
authors.initials: C
authors.lastname: Jones
keywords: Fluorescent cholangiography; Fluorophore; Imaging; Intraoperative cholangiography; Laparoscopic cholecystectomy