title: Indocyanine Green Near-Infrared Fluorescence in Pure Laparoscopic Living Donor Hepatectomy: a Reliable Road Map for Intra-Hepatic Ducts ?
abstract: Indocyanine green (ICG) near-infrared (NIR) fluorescence cholangiography (FC) has shown its usefulness to visualize the biliary ducts in open living donor hepatectomy (LDH) to check the intraoperative biliary anatomy. The fully laparoscopic LDH approach has been recently described. However, this procedure is very demanding for a possible misperception of right parenchymal transection line and the cut point of the lobar biliary ducts (BD). To explore the potential of ICG-NIR-FC method we report our experience in 11 fully laparoscopic left LDH using 5 different protocols. Protocol-A, consisted on intravenous (i.v.) ICG injection of 2.5 mg with immediate cut of the BD; -B, same dose and late cut; -C, 1 mg i.v. and late cut; -D, intra-cystic duct injection of 2.5 mg and immediate cut; -E, intra-cystic injection of 5 mg and immediate cut. Protocol-A showed fast fluorescence in the lobar artery and portal vein followed by the BD sheet; -B showed intraductal excretion with a high parenchymal signal; -C showed a very week signal; -D failed to visualize the ducts; -E showed a good signal without parenchymal fluorescence. ICG-NIR-FC is an additional method to visualize the lobar ducts in fully laparoscopy LDH, but still insufficient for the segmental ducts.
authors.affiliation: a Department of General, Hepatobiliary and Liver Transplantation Surgery, Ghent University Hospital and Medical School, Ghent , Belgium ;
authors.forename: F
authors.initials: F
authors.lastname: Tomassini
authors.affiliation: a Department of General, Hepatobiliary and Liver Transplantation Surgery, Ghent University Hospital and Medical School, Ghent , Belgium ;
authors.forename: A
authors.initials: A
authors.lastname: Scarinci
authors.affiliation: b Organ Transplant Center, MBC 96 King Faisal Specialist Hospital and Research Center, Riyadh , Saudi Arabia .
authors.forename: Y
authors.initials: Y
authors.lastname: Elsheik
authors.affiliation: a Department of General, Hepatobiliary and Liver Transplantation Surgery, Ghent University Hospital and Medical School, Ghent , Belgium ;
authors.forename: V
authors.initials: V
authors.lastname: Scuderi
authors.affiliation: b Organ Transplant Center, MBC 96 King Faisal Specialist Hospital and Research Center, Riyadh , Saudi Arabia .
authors.forename: D
authors.initials: D
authors.lastname: Broering
authors.affiliation: a Department of General, Hepatobiliary and Liver Transplantation Surgery, Ghent University Hospital and Medical School, Ghent , Belgium ;
authors.forename: R I
authors.initials: RI
authors.lastname: Troisi
mesh_terms: D001653:Bile Ducts, Intrahepatic / Q000000981:diagnostic imaging*; D002758:Cholangiography / Q000379:methods; D004396:Coloring Agents / Q000494:pharmacology*; D005260:Female; D005456:Fluorescent Dyes; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D007208:Indocyanine Green / Q000494:pharmacology*; D010535:Laparoscopy / Q000379:methods; D016031:Liver Transplantation / Q000379:methods; D019520:Living Donors; D008297:Male; D012494:Sampling Studies; D012680:Sensitivity and Specificity; D019265:Spectroscopy, Near-Infrared
chemical_list: D004396:Coloring Agents; D005456:Fluorescent Dyes; D007208:Indocyanine Green