Indocyanine Green Reinjection Technique for Use in Fluorescent Angiography Concomitant With Cholangiography During Laparoscopic Cholecystectomy

Background: For safe laparoscopic cholecystectomy, surgeons must possess detailed knowledge of the anatomy of the bile duct and arterial system as seen through a laparoscope. Study Design: We developed an indocyanine green (ICG) reinjection technique for use in fluorescent angiography. Here, we evaluated the efficacy of the ICG reinjection technique in fluorescent angiography in discriminating the arterial system with the concomitant use of fluorescent cholangiography. Results: Twenty-eight patients were enrolled in the study. All patients underwent laparoscopic cholecystectomy without complication. After reinjection of ICG during surgery, fluorescence of the cystic artery was visualized in 25 patients (89%). Conclusions: Fluorescent angiography using this ICG reinjection technique might enhance the safety of laparoscopic cholecystectomy.