The outcome of real-time evaluation of biliary flow using near-infrared fluorescence cholangiography with Indocyanine green in biliary atresia surgery.
Biliary atresia
ICG
Indocyanine green
Kasai portoenterostomy
Near-infrared fluorescence imaging
Journal
Journal of pediatric surgery
ISSN: 1531-5037
Titre abrégé: J Pediatr Surg
Pays: United States
ID NLM: 0052631
Informations de publication
Date de publication:
Dec 2019
Dec 2019
Historique:
received:
07
08
2019
accepted:
24
08
2019
pubmed:
3
10
2019
medline:
24
3
2020
entrez:
3
10
2019
Statut:
ppublish
Résumé
Indocyanine green (ICG) fluorescence imaging is a promising tool for intraoperative decision-making. The aim of this study was to evaluate the utility of near-infrared fluorescence cholangiography (NIR-FCG) with ICG in primary surgery for biliary atresia (BA). We performed NIR-FCG with ICG in 10 BA patients and observed the fluorescence of their hilar micro-bile ducts and hilar exudate in order to assess the appropriate level at which to dissect the hilar fibrous corn. We compared the jaundice outcome of 10 patients using NIR-FCG (Group A) to that of 35 historical patients in whom NIR-FCG had not been used (Group B). The mean age of patients was 74.8 days. The classification of BA was type I in two cases and type-III in eight cases. NIR-FCG visualized the hilar micro-bile ducts, and the incidence of positive fluorescence was 80%. The ratio of postoperative normalization of hyperbilirubinemia in Group A was significantly higher than that in Group B (1.0 vs. 0.65, p < 0.05). NIR-FCG provided important objectifiable information about the biliary structures in surgery of BA. Although the number of cases was small, our results suggest that NIR-FCG may be useful for improving the outcome of primary surgery for BA. Study of Diagnostic Test. Level III.
Sections du résumé
BACKGROUND
BACKGROUND
Indocyanine green (ICG) fluorescence imaging is a promising tool for intraoperative decision-making. The aim of this study was to evaluate the utility of near-infrared fluorescence cholangiography (NIR-FCG) with ICG in primary surgery for biliary atresia (BA).
METHODS
METHODS
We performed NIR-FCG with ICG in 10 BA patients and observed the fluorescence of their hilar micro-bile ducts and hilar exudate in order to assess the appropriate level at which to dissect the hilar fibrous corn. We compared the jaundice outcome of 10 patients using NIR-FCG (Group A) to that of 35 historical patients in whom NIR-FCG had not been used (Group B).
RESULTS
RESULTS
The mean age of patients was 74.8 days. The classification of BA was type I in two cases and type-III in eight cases. NIR-FCG visualized the hilar micro-bile ducts, and the incidence of positive fluorescence was 80%. The ratio of postoperative normalization of hyperbilirubinemia in Group A was significantly higher than that in Group B (1.0 vs. 0.65, p < 0.05).
CONCLUSION
CONCLUSIONS
NIR-FCG provided important objectifiable information about the biliary structures in surgery of BA. Although the number of cases was small, our results suggest that NIR-FCG may be useful for improving the outcome of primary surgery for BA.
TYPE OF STUDY
METHODS
Study of Diagnostic Test.
LEVEL OF EVIDENCE
METHODS
Level III.
Identifiants
pubmed: 31575415
pii: S0022-3468(19)30569-X
doi: 10.1016/j.jpedsurg.2019.08.029
pii:
doi:
Substances chimiques
Indocyanine Green
IX6J1063HV
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2574-2578Informations de copyright
Copyright © 2019 Elsevier Inc. All rights reserved.