Indocyanine green fluorescence imaging via endoscopic nasal biliary drainage during laparoscopic deroofing of liver cysts

• Main Authors: Akira Umemura, Hiroyuki Nitta, Takayuki Suto, Hisataka Fujiwara, Takeshi Takahara, Yasushi Hasegawa, Hirokatsu Katagiri, Shoji Kanno, Taro Ando, Akira Sasaki
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2021-01-01
• Series: Journal of Minimal Access Surgery
• Subjects: endoscopic nasal biliary drainage; indocyanine green; laparoscopic deroofing; linear stapler; liver cyst
• Online Access: http://www.journalofmas.com/article.asp?issn=0972-9941;year=2021;volume=17;issue=1;spage=131;epage=134;aulast=
• ISSN: 0972-9941; 1998-3921

Laparoscopic deroofing of liver cysts is widely accepted as the treatment of symptomatic huge liver cysts. As bile leakage is a common complication of this procedure, indocyanine green (ICG) imaging has played an active role in detecting intrahepatic biliary tract. However, infusion ICG imaging needs time rag after injection due to moving from bloodstream to bile, and also, additional injection is needed when the fluorescent imaging is not clear. To cover this weakness of ICG imaging, we first applied ICG imaging via 5-Fr endoscopic nasal biliary drainage (ENBD) during laparoscopic deroofing of liver cysts. This technique promptly gives us ICG imaging after ICG injection from ENBD; in addition, direct ICG imaging sometimes reveals minor leakage from sealing line and staple lines; therefore, we believe that direct ICG imaging via ENBD helps us to prevent post-operative bile leakage.