Автори: Michael P. Stolz, Edward N. Foxhall, Brian H. Gibson, Sujata Gill, Molly M. McNamee
<jats:sec>Background During a laparoscopic cholecystectomy, the critical view of safety is obtained through dissection of the gallbladder from the liver until there is anterior and posterior visualization of the cystic duct and cystic artery. This view is used to allow for proper identification of the cystic duct and artery that will be clipped and incised during the operation. Indocyanine green (ICG) can be used during the operation to directly visualize the biliary tract because of its excretion through the biliary system and elimination via the GI tract. Using a laparoscope capable of visualizing ICG allows for identification of bile duct anatomy to include: common hepatic bile duct, cystic duct, and aberrant, or accessory bile ducts. Additionally, visualization of the biliary structures using ICG prior to clipping and incision will allow for identification and prevention of missed biliary anatomy which could reduce incidence of bile leak, a known complication of cholecystectomies. We propose that visualization of the critical view of safety with ICG fluoroscopy be termed the critical view of safety plus. </jats:sec><jats:sec>Purpose We hypothesized that using the critical view of safety plus method for laparoscopic cholecystectomy will yield better scores and increase the decision of the control surgeon to choose to cut and proceed with the operation when compared with the traditional critical view of safety. </jats:sec><jats:sec>Research Design Comparision of operative photos of critical view of safety and critical view of safety plus which were randomized, double blinded, and graded by a single control surgeon. </jats:sec><jats:sec>Study Sample Our study consisted of fifty patients of which 72% female (n = 36) and 28% male (n = 14). The ethnic background included 76% non-Hispanic (n = 38) and 24% Hispanic or of Latino/a origin (n = 12). The average age of our patient was 49 years old (range 20 to 93 years old). Inclusion criteria consisted of patients undergoing laparoscopic cholecystectomy greater than or equal to 18 years old. Exclusion criteria included allergy to indocyanine dye or iodine and pregnancy. </jats:sec><jats:sec>Analysis The scores were evaluated using Chi-squared and paired T-test analysis using MedCalc, MedCalc Sofware Ltd, Belgium. </jats:sec><jats:sec>Results The decision to cut and proceed with the operation was chosen 29 times (58%) when viewing the critical view of safety plus vs 22 times (44%) with the critical view of safety (χ2 = 65.822, p < 0.0001). The decision to proceed with further dissection to isolate the cystic duct viewing the critical view of safety plus was chosen 8 times (16%) vs 11 times (22%) with critical view of safety (χ2 = 65.822, p < 0.0001) as shown in Fig. 2. The comparison of total scores with critical view of safety plus vs critical view of safety showed an average of 4.36 vs 4.04, p = 0.0733. The critical view of safety plus and critical view of safety individual criteria scores are: “two structures connected to the gallbladder” (average 1.54 vs 1.50, p = 0.598), “cystic plate clearance” (average 1.42 vs 1.28, p = 0.018), and “hepatocystic triangle clearance” (average 1.4 vs 1.26, p =0.0334). </jats:sec><jats:sec>Conclusion We recommend routine use of ICG fluoroscopy to obtain the critical view of safety plus to allow for improved visualization of the biliary tree, identification of aberrant biliary anatomy, and the potential to reduce risk of bile duct injury. </jats:sec>
Knowledge, attitudes and practices of using Indocyanine Green (ICG) fluorescence in emergency surgery: an international web-based survey in the ARtificial Intelligence in Emergency and trauma Surgery (ARIES)—WSES project
Belinda De Simone, Fikri M. Abu-Zidan, Sara Saeidi, Genevieve Deeken, Walter L. Biffl, Ernest E. Moore, Massimo Sartelli, Federico Coccolini, Luca Ansaloni, Salomone Di Saverio, Luigi Boni, Gian Luca Baiocchi, Elisa Cassinotti, Michele Diana, Ana Maria Gonzalez-Castillo, Francesco Di Maggio, Antonio Tarasconi, Hung Truong, Adam Peckham-Cooper, Aishath Azna Ali, Aitor Landaluce-Olavarria, Alan Biloslavo, Alberto Sartori, Aleix Martínez-Pérez, Aleksandar Karamarkovic, Alessandra Marano, Alessandro Bergna, Alessio Giordano, Alexander Julianov, Alexandros Chamzin, Alexandros Chamzin, Alexis Theodorou, Alfie J. Kavalakat, Amedeo Antonelli, Amit Gupta, Ana-Maria Musina, Andee Dzulkarnaen Zakaria, Andrea Balla, Andrea Barberis, Andrea Cavallaro, Andrew Gumbs, Andrey Litvin, Antonio Pesce, Arda Isik, Aristeidis Papadopoulos, Asyraf Bin Mohd Zuki, Barbara Petronio, Beatrice Torre, Biagio Picardi, Boyko Atanasov, Charalampos Seretis, Chiara fantozzi, Christos Chouliaras, Christos Doudakmanis, Claudia Zaghi, Damien Massalou, Daniele Delogu, Daniele Morezzi, Danilo Vinci, Daunia Verdi, Davide Luppi, Davide Papis, Nicola DéAngelis, Desire Pantalone, Diego Coletta, Diego Visconti, Diletta Corallino, Dimitrios Oikonomou, Dimitrios Schizas, Dionysios Prevezanos, Dmitry Adamovich, Edoardo Baldini, Eftychios Lostoridis, Elena-Adelina Toma, Elisa Reitano, Enrico Pinotti, Ernest Moore, Evgeni Dimitrov, Fabio Marino, Fabrizio D’Acapito, Fausto Rosa, Felipe Pareja-Ciuro, Filipe Ramalho de Almeida, Firdaus Hayati, Flavio Milana, Francesca Pecchini, Francesco Pata, Francesk Mulita, Gabriela Arroyo Murillo, Gennaro Martines, Gennaro Perrone, Georgios Ioannis Verras, Georgios Zacharis, Gian Luca Baiocchi, Gianluca Pellino, Gianluca Vanni, Gianmaria Casoni Pattacini, Giorgio Giraudo, Giuseppe Brisinda, Giuseppe Curro, Giuseppe Evola, Giuseppe Palomba, Goran Augustin, Guglielmo Niccolò Piozzi, Gustavo Miguel Machain, Hazim Eltyeb, Heba Taher, Huseyin Kemal Rasa, Ibrahim Umar Garzali, Igor A. Kryvoruchko, Imtiaz Wani, Isidoro Di Carlo, Jacopo Andreuccetti, Jin Jiun Mah, Juan Carlos Salamea, Justin Davies, Kenneth Y. Y. Kok, Konstantinos Perivoliotis, Lali Patsia, Larysa Sydorchuk, Leandro Siragusa, Lorenzo Petagna, Lovenish Bains, Luca Ferrario, Luigi Eduardo Conte, Luis Tallon-Aguilar, Lukas Werner Widmer, Maciej, Mahir Gachabayov, Marco Clementi, Marco Materazzo, Marco Pellicciaro, Maria Papadoliopoulou, Marianna Capuano, Mario Giuffrida, Mario Serradilla-Martín, Massimiliano Veroux, Massimo Chiarugi, Matteo Santoliquido, Mauro Podda, Maximilian Scheiterle, Mercedes Estaire-Gómez, Micaela Piccoli, Michele Ammendola, Mihail Slavchev, Mika Ukkonen, Mirko Barone, Mohamed Arif, Hameed Sulta, Monica Ortenzi, Monika Gureh, Nicola Cillara, Nikolaos Michalopoulos, Nikolaos Pararas, Octavian Enciu, Orestis Ioannidis, Pasquale Cianci, Pierpaolo Sileri, Pietro Fransvea, Piotr Major, Ruslan Sydorchuk, Sara Ingallinella, Selmy S. Awad, Semra Demirli Atici, Sentilnathan Subramaniam, Serge Chooklin, Serhat Meric, Sharfuddin Chowdhury, Simone Gargarella, Sofia Xenaki, Stefano Olmi, Stefano Rossi, Theodoros Sidiropoulos, Timothy Craig Hardcastle, Valentin Calu, Vasilescu Alin Mihai, Victor Lopez-Lopez, Vincenza Paola Dinuzzi, Vincenzo Trapani, Vishal Shelat, Zaza Demetrashvili, Fausto Catena, ICG Fluorescence Guided Emergency Surgery Survey Consortium
https://doi.org/10.1007/s13304-024-01853-z
2024, Updates in Surgery
Scopus
WoS
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