Uso de verde de indocianina para prevenir lesiones yatrogénicas de la vía biliar durante colecistectomía laparoscópica

  1. B Pérez Saborido 1
  2. Miguel Toledano Trincado
  3. David Pacheco Sánchez
  1. 1 Unidad de Cirugía Hepatobiliar y Pancreática. Unidad de Trasplante Hepático. Servicio de Cirugía General y Aparato Digestivo. Hospital Universitario Río Hortega. Valladolid.
Journal:
Cirugía Andaluza

ISSN: 2695-3811,  1130-3212

Year of publication: 2019

Volume: 30

Issue: 2

Pages: 228-234

Type: Article

DOI: 10.37351/2019302.13 DIALNET GOOGLE SCHOLAR lock_openDialnet editor

More publications in: Cirugía Andaluza

Sustainable development goals

Abstract

Iatrogenic lesions of the bile duct represent a major problem with an incidence in laparoscopic cholecystectomy of 0.4-0.6%. Many measures have been postulated to avoid it and among them the most important is the correct identification of the extrahepatic biliary anatomy using the surgical technique of the critical vision of safety. The use of classical cholangiography in a routine manner is not agreed upon, but in recent years, the appearance of fluorescent cholangiography with indocyanine green seems to be a very effective tool in the correct identification of the cystic duct and the main bile duct and therefore a support measure to avoid biliary injuries. Many experience in laparoscopic and robotic surgery have been published with very good results. The fundamental problem is to define the dose of indocyanine green to be administered and with what advance at the time of surgery to achieve a better definition of the image. On the other hand, the penetration of current light sources is 5-10 mm and therefore it can be difficult to visualize the biliary structures when the tissues are thickened as in obesity, acute cholecystitis ... In spite of all this, it is an easy, inexpensive and very well received technique among surgeons, which can be used to reduce the incidence of biliary lesions during cholecystectomy procedures by minimally invasive approach.

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