Background : Laparoscopic cholecystectomy is the standard treatment in acute cholecystitis which lowers morbidity and hospital stay when compared with open cholecystectomy. The complications of laparoscopic cholecystectomy are bile duct injury and bleeding. Indocyanine green (ICG) is excreted in bile and provides benefit in bile duct visualization and identification anatomy. ICG assisted laparoscopic cholecystectomy can prevent complications.

Methods : A Thai 49-year-old man with diagnosed with acute cholecystitis grade II followed Tokyo guideline for 2018 and had got antibiotic intravenous injection. He has been transferred to tertiary center. CT whole abdomen was performed and identified acute calculus cholecystitis with pericholecystic fluid with adjacent inflammation at hepatic flexure. We planned to perform laparoscopic cholecystectomy.ICG 2.5 mg intravenous injection was performed one hour before operation. Camera pot insertion at umbilical and other port at subxiphoid and subcostal insertion.

Results : We found adhesion and hepatic flexure colon attach to gallbladder and thick fibrous tissue around Hepatocystic triangle. Operative time was 2.5 hours with intraoperative blood loss 100 ml. There was no serious postoperative complication. Patient was discharge at day 6 with uneventful.

Conclusions : ICG can enhance bile duct visualization and prevent bile duct injury. ICG can be new standard technology assisted laparoscopic surgery.