Indocyanine green fluorescent cholangiography and intraoperative angiography with laparoscopic cholecystectomy: a randomized controlled trial

Introduction Laparoscopic cholecystectomy (LC) is the standard of care in the management of a diseased gall bladder. Sometimes it is complicated by bile duct injury, a significant cause of morbidity and mortality. Efforts are continuous to develop a standard technique to do it safely. Indocyanine green (ICG), fluorescent cholangiography was proposed to serve this cause. Patients and methods A double-blinded, randomized, controlled trial involved patients who underwent LC in Ain-Shams University Specialized Hospital from January 2020 till July 2021. Group A (n=60) underwent LC using the usual white light; group B (n=58) underwent LC with ICG florescence cholangiography and intraoperative ICG florescence arteriography. Results Females represented 78%, the mean age was 42.4 years, and the median BMI was 35.5. ICG was injected at a median time of 6.5 h before surgery. The blood loss was comparable between the two groups. In group B, all three structures were clearly identified in nearly all the patients. The common hepatic duct identification rate was 96.5% (P