Francisco Suárez Anzorena

Fluorescence Cholangiography in Laparoscopic Cholecystectomy Experience in Argentina

The frequency of laparoscopic cholecystectomies in Argentina has increased in the last few years. The use of intraoperative methods for the detection of bile ducts such as intraoperative cholangiography (IOC) varies within the country although it is a routine procedure in our workplace. Surgical injuries in bile ducts remain a constant, amounting to about 0.4%. This is the reason why we have been looking for an easy alternative to IOC, with the aim to reduce those numbers. Sponsored by the company Karl Storz, in 2011 we started performing fluorescence cholangiography in our laparoscopic cholecystectomies; we have kept those records prospectively and now have a total of 65 cases. The use of this method seems promising with some clear advantages such as its low cost, real-time performance and the possibility to visualize structures before they are sectioned. We have been able to visualize the main bile duct without dissection in 89.5% of the cases. Areas that still need improvement include some technical issues such as the depth for visualization in obese patients or in those with severe or substantially chronic inflammatory stages where the light cannot penetrate tissues appropriately.