Comparison Of Laparoscopic Cholecystectomy With And Without The Use Of Indocyanine Green Dye A 1 Year Observational Cohort Study At A Tertiary Hospital In Belagavi

Abstract

Gall stone disease is one of the most common pathologies encountered in surgical wards these days, With 10-15% of the general population suffering from symptomatic or asymptomatic cholelithiasis, which makes it one of the most common pathologies of gall bladder and biliary tree. Laparoscopic cholecystectomy is currently considered as the gold standard treatment for the same. However with the increase in laparoscopic cholecystectomies the incidence of bile duct injuries has also increased. Various factors like adhesions, altered biliary anatomy and edematous biliary anatomy can lead to BDI. In this study laparoscopic cholecystectomies were performed with and without the use of Indocyanine Green dye. The aim of this study was to know the effectiveness of ICG in clearly delineating the biliary anatomy and determine the perioperative complication rates. 2.5mg of ICG dye was given 1 hour 30minutes to 2 hours preoperatively. A total of 68 cases were included in this study with 50% of them performed with the use of ICG dye. The time taken to identify the critical view of safety(CVS) and the identification rates of cystic duct, common bile duct and common hepatic duct were calculated. It was observed that of the two groups the CVS was achieved significantly faster with a mean time of 24.2 minutes in the ICG group whereas 36.7 minutes in the control group. The overall time for surgery was also significantly better in ICG group with a mean time of 58.4mins. Similarly identification rates of Cystic duct, CBD and CHD were much higher in ICG group with identification rates of 82%, 67% and 55% respectively. The xv identification of CBD was significantly better with ICG as compared to that without ICG, with a p value of 0.05. No significant difference was seen between the postoperative complications, length of hospital stay and rates of conversion to open. Thus this study concluded that laparoscopic cholecystectomies with the use of ICG dye have a better overall surgical outcome with significantly better identification of the biliary anatomy.