Optimizing the image of fluorescence cholangiography using ICG: a systematic review and ex vivo experiments

Surgical Endoscopy
Jacqueline van den BosLaurents P S Stassen

Abstract

Though often only briefly described in the literature, there are clearly factors that have an influence on the fluorescence intensity, and thereby the usefulness of the technique. This article aims to provide an overview of the factors influencing the fluorescence intensity of fluorescence imaging with Indocyanine green, primarily focussed on NIRF guided cholangiography. A systematic search was conducted to gain an overview of currently used methods in NIRF imaging in laparoscopic cholecystectomies. Relevant literature was searched to gain advice on what methods to use. Ex vivo experiments were performed to assess various factors that influence fluorescence intensity and whether the found clinical advices can be confirmed. ICG is currently the most widely applied fluorescent dye. Optimal ICG concentration lies between 0.00195 and 0.025 mg/ml, and this dose should be given as early as achievable-but maximum 24 h-before surgery. When holding the laparoscope closer and perpendicular to the dye, the signal is most intense. In patients with a higher BMI and/or cholecystitis, fluorescence intensity is lower, but NIRF seems to be more helpful. There are differences between various marketed fluorescence systems. Also, no uniform method...Continue Reading

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Citations

Jul 2, 2019·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Jacqueline van den BosLaurents P S Stassen
May 13, 2020·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Lu LuJin-Hong Chen
Dec 15, 2020·World Journal of Gastroenterology : WJG·Sang-Ho ParkGyung Mo Son
Apr 25, 2021·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·Hong-Min AhnKwang-Ryul Baek
Dec 23, 2020·Annals of Surgery·Xiaoying WangNorihiro Kokudo
Dec 20, 2019·Bioconjugate Chemistry·Albertus Wijnand HensbergenFijs W B van Leeuwen

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Methods Mentioned

BETA
imaging techniques
imaging technique
fluorescence-imaging
fluorescence imaging
Fluorescence
dissection
irradiate
IEC

Software Mentioned

Photoshop
Osirix
ImageJ

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