Ann Surg Treat Res.  2017 Jan;92(1):47-50. 10.4174/astr.2017.92.1.47.

Cystic duct variation detected by near-infrared fluorescent cholangiography during laparoscopic cholecystectomy

• Kim NS
• Jin HY
• Kim EY
• Hong TH

• KMID: 2364714
• DOI: http://doi.org/10.4174/astr.2017.92.1.47

Abstract

Near-infrared fluorescent cholangiography (NIRFC) is an emerging technique for easy intraoperative recognition of biliary anatomy. We present a case of cystic duct variation detected by NIRFC which had a potential risk for biliary injury if not detected. A 32-year-old female was admitted to the Seoul St. Mary's Hospital for surgery for an incidental gallbladder polyp. We performed laparoscopic cholecystectomy with NIRFC. In fluorescence mode, a long cystic duct and an accessory short hepatic duct joining to the cystic duct were found and the operation was completed safely. The patient recovered successfully. NIRFC is expected to be a promising procedure that will help minimize biliary injury during laparoscopic cholecystectomy.

Keyword

Near-infrared fluorescent cholangiography; Cystic duct variation; Laparoscopic cholecystectomy

MeSH Terms

Adult
Cholangiography*
Cholecystectomy, Laparoscopic*
Cystic Duct*
Female
Fluorescence
Gallbladder
Hepatic Duct, Common
Humans
Polyps
Seoul

Figure

• 

  Fig. 1 (A) Intraoperative anatomic view. (B) Long cystic duct found by fluorescent intraoperative cholangiography after intravenous injection of indocyanine green.

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  Fig. 2 (A) Intraoperative identification of biliary structures with conventional mode (arrow). (B) Near-infrared fluorescent cholangiography reveals the accessory hepatic duct joining to the cystic duct (arrow). (C) A schematic diagram depicting the anomaly we experienced.

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