Experience of indocyanine green use in acute calculous cholecystitis

Klimov A.E.

Peoples’ Friendship University of Russia named after Patrice Lumumba;
City Clinical Hospital named after V.V. Vinogradov

ORCID: 0000-0002-1397-9540

Leonovich A.M.

Peoples’ Friendship University of Russia named after Patrice Lumumba;
City Clinical Hospital named after V.V. Vinogradov

Kosachenko M.V.

Peoples’ Friendship University of Russia named after Patrice Lumumba;
City Clinical Hospital named after V.V. Vinogradov

ORCID: 0000-0002-9735-6219

Barkhudarov A.A.

Peoples’ Friendship University of Russia named after Patrice Lumumba;
City Clinical Hospital named after V.V. Vinogradov

ORCID: 0000-0002-7494-013X

Experience of indocyanine green use in acute calculous cholecystitis

Authors:

Klimov A.E., Leonovich A.M., Kosachenko M.V., Barkhudarov A.A.

More about the authors

Journal: Pirogov Russian Journal of Surgery. 2024;(8): 52‑56

DOI: 10.17116/hirurgia202408152

Downloaded: 7

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To cite this article:

Klimov AE, Leonovich AM, Kosachenko MV, Barkhudarov AA. Experience of indocyanine green use in acute calculous cholecystitis. Pirogov Russian Journal of Surgery. 2024;(8):52‑56. (In Russ.)
https://doi.org/10.17116/hirurgia202408152

Подписка 2025-2 (Pirogov Russian Journal of Surgery)

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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 after, but no later than 6 hours. This allows to achieve the most comfortable fluorescence of the extrahepatic biliary tract. The drug concentration in the liver cells decreases by this time and increases in the biliary tract. It is not always possible to perform the operation strictly within the specified time limit considering the urgency of the surgical intervention. In this connection, the surgery was carried out not earlier than 3 hours after the drug injection, but not later than 6 hours. Endoscopic equipment with the ability to display near-infrared fluorescence was used. A laser light source with a wavelength of 820 nm in the Arthrex imaging system with 4K resolution as well as the Olympus imaging system with HD resolution were used for fluorescence excitation.

RESULTS

The implementation of intraoperative fluorescent navigation with indocyanine green contributes to the improvement of safety and effectiveness of surgical treatment through visualization of topography and identification of anatomical variants of the biliary tree; possibilities of prevention and timely detection of intraoperative complications. The use of indocyanine green allows to intraoperatively reveal atypical location and different variations of the extrahepatic biliary tract.

Keywords:

indocyanine green

acute calculous cholecystitis

surgical treatment

Authors:

Klimov A.E.

Peoples’ Friendship University of Russia named after Patrice Lumumba;
City Clinical Hospital named after V.V. Vinogradov

ORCID: 0000-0002-1397-9540

Leonovich A.M.

Peoples’ Friendship University of Russia named after Patrice Lumumba;
City Clinical Hospital named after V.V. Vinogradov

Kosachenko M.V.

Peoples’ Friendship University of Russia named after Patrice Lumumba;
City Clinical Hospital named after V.V. Vinogradov

ORCID: 0000-0002-9735-6219

Barkhudarov A.A.

Peoples’ Friendship University of Russia named after Patrice Lumumba;
City Clinical Hospital named after V.V. Vinogradov

ORCID: 0000-0002-7494-013X

Received:

10.07.2024

Accepted:

28.07.2024

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