Detailed Abstract
[E-poster - Biliary & Pancreas (Biliary Disease/Surgery)]
[EP 162] Intraoperative ICG As a Safety Guide for Minimally Invasive Cholecystectomy in Acute Cholecystitis
Naru KIM 1, Keehwan KIM 2
1 Hepatobiliary-pancreatic Surgery , Ewha Womans University Mokdong Hospital, REPUBLIC OF KOREA, 2 Hepatobiliary-pancreatic Surgery , The Catholic University of Korea Uljeongbu St. Mary's Hospital, REPUBLIC OF KOREA
Background : Performing a successful minimal invasive cholecystectomy (MIC) in patients with acute cholecystitis (AC) with severe inflammation and fibrosis can sometimes be challenging. Intraoperative cholangiography with indocyanine green(ICG) may be a way to reduce the risk of complications such as bile duct injury and open conversion when performing MIC
Methods : This study included patients who underwent MIC from June 2019 to December 2022, and retrospectively analysed the difference in surgical outcomes between the ICG group and the non-ICG group.
Results : Out of a total of 225 patients, 118 were in the ICG group and 107 in the non-ICG group. The complication rate of bile duct injury or Clavien-Dindo classification IIIa or higher was not significantly different between the two groups, nor was the rate of complete cholecystectomy. The rate of intraoperative confirmation of critical view of safety(CVS) was higher in the ICG group (91.4% vs. 73.9%, p=0.022), especially in patients with Parkland grade 4 and 5 (100% vs 62.5%, p=0.032 and 97.2% vs 73.9, p=0.011) respectively, confirming that ICG can be a useful guide to obtain CVS in high severity grade groups. Of the 118 patients in the ICG group, 102 (86.4%) could identify the bile duct and 16 (13.6%) could not identify the biliary structure.
Conclusions : ICG can identify the biliary structure in a high rate with severe AC, which can be used as a useful guide when performing MIC, as it can secure CVS in a higher rate.
Methods : This study included patients who underwent MIC from June 2019 to December 2022, and retrospectively analysed the difference in surgical outcomes between the ICG group and the non-ICG group.
Results : Out of a total of 225 patients, 118 were in the ICG group and 107 in the non-ICG group. The complication rate of bile duct injury or Clavien-Dindo classification IIIa or higher was not significantly different between the two groups, nor was the rate of complete cholecystectomy. The rate of intraoperative confirmation of critical view of safety(CVS) was higher in the ICG group (91.4% vs. 73.9%, p=0.022), especially in patients with Parkland grade 4 and 5 (100% vs 62.5%, p=0.032 and 97.2% vs 73.9, p=0.011) respectively, confirming that ICG can be a useful guide to obtain CVS in high severity grade groups. Of the 118 patients in the ICG group, 102 (86.4%) could identify the bile duct and 16 (13.6%) could not identify the biliary structure.
Conclusions : ICG can identify the biliary structure in a high rate with severe AC, which can be used as a useful guide when performing MIC, as it can secure CVS in a higher rate.
SESSION
E-poster
E-Session 03/21 ALL DAY