title: Mechanism of dynamic near-infrared fluorescence cholangiography of extrahepatic bile ducts and applications in detecting bile duct injuries using indocyanine green in animal models.
abstract: Fluorescence intraoperative cholangiography (IOC) is a potential alternative for identifying anatomical variation and preventing iatrogenic bile duct injuries by using the near-infrared probe indocyanine green (ICG). However, the dynamic process and mechanism of fluorescence IOC have not been elucidated in previous publications. Herein, the optical properties of the complex of ICG and bile, dynamic fluorescence cholangiography and iatrogenic bile duct injuries were investigated. The emission spectrum of ICG in bile peaked at 844 nm and ICG had higher tissue penetration. Extrahepatic bile ducts could fluoresce 2 min after intravenous injection, and the fluorescence intensity reached a peak at 8 min. In addition, biliary dynamics were observed owing to ICG excretion from the bile ducts into the duodenum. Quantitative analysis indicated that ICG-guided fluorescence IOC possessed a high signal to noise ratio compared to the surrounding peripheral tissue and the portal vein. Fluorescence IOC was based on rapid uptake of circulating ICG in plasma by hepatic cells, excretion of ICG into the bile and then its interaction with protein molecules in the bile. Moreover, fluorescence IOC was sensitive to detect bile duct ligation and acute bile duct perforation using ICG in rat models. All of the results indicated that fluorescence IOC using ICG is a valid alternative for the cholangiography of extrahepatic bile ducts and has potential for measurement of biliary dynamics.
authors.affiliation: Department of Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Gao
authors.affiliation: Department of Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
authors.forename: Min
authors.initials: M
authors.lastname: Li
authors.affiliation: Department of Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
authors.forename: Zi-Fang
authors.initials: ZF
authors.lastname: Song
authors.affiliation: Department of Breast and Thyroid Surgery, Puai Hospital, Wuhan, 430035, China.
authors.forename: Le
authors.initials: L
authors.lastname: Cui
authors.affiliation: Department of Breast and Thyroid Surgery, Puai Hospital, Wuhan, 430035, China.
authors.forename: Bi-Rong
authors.initials: BR
authors.lastname: Wang
authors.affiliation: Key Laboratory for Large-Format Battery Materials and System, Ministry of Education, School of Chemistry and Chemical Engineering, Huazhong University of Science and Technology, Wuhan, 430074, China.
authors.forename: Xiao-Ding
authors.initials: XD
authors.lastname: Lou
authors.affiliation: Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Zhou
authors.affiliation: Department of Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China. qc_zheng@hust.edu.cn.
authors.forename: Qi-Chang
authors.initials: QC
authors.lastname: Zheng
mesh_terms: D000818:Animals; D001649:Bile Duct Diseases / Q000000981:diagnostic imaging* / Q000209:etiology; D017734:Bile Ducts, Extrahepatic / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D002758:Cholangiography / Q000379:methods*; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects; D004195:Disease Models, Animal; D005456:Fluorescent Dyes / Q000008:administration & dosage*; D007049:Iatrogenic Disease; D007208:Indocyanine Green / Q000008:administration & dosage*; D007275:Injections, Intravenous; D007432:Intraoperative Period; D051381:Rats; D059629:Signal-To-Noise Ratio
chemical_list: D005456:Fluorescent Dyes; D007208:Indocyanine Green
keywords: bile duct injury; indocyanine green; intraoperative cholangiography; near-infrared fluorescence imaging