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Usefulness of intraoperative fluorescence imaging to evaluate local anatomy in hepatobiliary surgery
Author(s) -
Mitsuhashi Noboru,
Kimura Fumio,
Shimizu Hiroaki,
Imamaki Mizuho,
Yoshidome Hiroyuki,
Ohtsuka Masayuki,
Kato Atsushi,
Yoshitomi Hideyuki,
Nozawa Satoshi,
Furukawa Katsunori,
Takeuchi Dan,
Takayashiki Tsukasa,
Suda Kosuke,
Igarashi Tatsuo,
Miyazaki Masaru
Publication year - 2008
Publication title -
journal of hepato‐biliary‐pancreatic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 0944-1166
DOI - 10.1007/s00534-007-1307-5
Subject(s) - indocyanine green , medicine , cholecystectomy , anastomosis , artery , bile duct , intrahepatic bile ducts , radiology , gallbladder , cholangiography , cystic duct , fibrous capsule of glisson , blood flow , vein , anatomy , pathology , surgery
Background/Purpose One of the major complications encountered in hepatobiliary surgery is the incidence of bile duct and blood vessel injuries. It is sometimes difficult during surgery to evaluate the local anatomy corresponding to hepatic arteries and bile ducts. We investigated the potential utility of an infrared camera system as a tool for evaluating local anatomy during hepatobiliary surgery. Methods An infrared camera system was used to detect indocyanine green fluorescence in vitro. We also employed this system for the intraoperative fluorescence imaging of the arteries and biliary system in a pig. Further, we evaluated blood flow in the hepatic artery, portal vein, and liver parenchyma during a human liver transplant and we investigated local anatomy in patients undergoing cholecystectomy. Results Fluorescence confirmed that indocyanine green was distributed in serum and bile. In the pig study, we confirmed the fluorescence of the biliary system for more than 1 h. In the liver transplant recipient, blood flow in the hepatic artery and portal vein was confirmed around the anastomosis. In most of the patients undergoing cholecystectomy, fluorescence was observed in the gallbladder, cystic and common bile ducts, and hepatic and cystic arteries. Conclusions Intraoperative fluorescence imaging in hepatobiliary surgery facilitates better understanding of the anatomy of arteries, the portal vein, and bile ducts.