Indocyanine Green Fluorescent Cholangiography During Laparoscopic Cholecystectomy and Bile Duct Injury.
Indocyanine green use is associated with lower common bile duct injury rates.
Indocyanine Green Fluorescent Cholangiography During Laparoscopic Cholecystectomy and Bile Duct Injury.
IMPORTANCE: Common bile duct (common bile duct) injury is a rare but devastating complication of laparoscopic cholecystectomy.
To evaluate the association between intraoperative indocyanine green use and common bile duct injury after laparoscopic cholecystectomy.
DESIGN, SETTING, AND PARTICIPANTS: This cohort study included data from multiple hospitals in the Epic Cosmos dataset for adult patients (18 years and older) undergoing laparoscopic cholecystectomy between 2016 and 2024.
using ICG leads to a 38% lower chance of common bile duct injury
Among them, 118 626 (72.0) were female and 46 069 (28.0) were male; the mean (SD) age was 51 (17) years.
Indocyanine green use increased from 1143 patients (1.6%) in 2016 to 47 816 (26%) in 2024.
In this large national cohort, intraoperative indocyanine green use was associated with lower rates of common bile duct injury, fewer postoperative biliary procedures and nonbiliary complications, and reduced conversion to open surgery.
These findings support the use of indocyanine green to enhance biliary safety in laparoscopic cholecystectomy and demonstrate its utility in reducing common bile duct injury.