000161006 001__ 161006
000161006 005__ 20251017144643.0
000161006 0247_ $$2doi$$a10.1007/s13304-025-02240-y
000161006 0248_ $$2sideral$$a144192
000161006 037__ $$aART-2025-144192
000161006 041__ $$aeng
000161006 100__ $$aCarramiñana-Nuño, R.$$uUniversidad de Zaragoza
000161006 245__ $$aRole of intraoperative indocyanine green roadmap as a safety measure in emergent laparoscopic cholecystectomy
000161006 260__ $$c2025
000161006 5060_ $$aAccess copy available to the general public$$fUnrestricted
000161006 5203_ $$aAcute cholecystitis is a growing pathology, with high surgical risk due to the related patients’ comorbidity. The gold standard treatment is laparoscopic cholecystectomy, which, despite its high volume, still presents elevated rates of biliary tract injury. Standardization of the procedure and accurate identification of the anatomical structures of the biliary tree are the key in avoiding severe complications associated with this injury. Innovation in minimally invasive technologies, such as infrared indocyanine green as a radiotracer to delimit the biliary anatomy, could reduce the rate of biliary tract lesions. A single-center case–control study was conducted, including patients undergoing emergency surgery between November 2023 and November 2024 for acute cholecystitis (Tokyo Guidelines 2018 criteria). Eighty-seven patients were allocated into two groups: emergency laparoscopic cholecystectomy with or without intraoperative indocyanine green cholangiography. The primary aim was to evaluate ICG’s impact on reducing bile duct injury. Secondary outcomes included operative time, hospital stay, and conversion rates. The mean operative time (93 min vs. 104.6 min, p = 0.087), ASA scale (p = 0.302) and Charlson comorbidity index (2.55 vs. 2.84; p = 0.58) were not significantly different when comparing both groups. The control group showed duplicated preoperative CRP values as compared to the ICG group (138.24 mg/l vs. 71.02 mg/l; p = 0.06), and a higher median hospital stay (5 days ± 3 vs. 3 days ± 1.75; p = 0.001). The control group showed a greater need for conversion to open surgery (14.3% vs. 0%; p = 0.015). Trends towards fewer bile duct injuries (0% vs. 4.1%; p = 0.208) and fewer complications (15.87% vs. 18.4%; p = 0.752) in the ICG group were not statistically significant. The use of ICG may reduce the need for conversion to open surgery and median hospital stay. However, its use has not been proven to reduce bile duct injury, postoperative complications, or operative time.
000161006 540__ $$9info:eu-repo/semantics/embargoedAccess$$aby-nc-nd$$uhttps://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
000161006 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/acceptedVersion
000161006 700__ $$0(orcid)0000-0002-7875-3550$$aBorrego-Estella, V.$$uUniversidad de Zaragoza
000161006 700__ $$aMillán-Mateos, A.
000161006 700__ $$0(orcid)0000-0001-9966-3821$$aMedina-Mora, L.$$uUniversidad de Zaragoza
000161006 700__ $$aGasós-García, M.
000161006 700__ $$aOtero-Romero, D.
000161006 700__ $$aSoriano-Liébana, MM.
000161006 700__ $$aLete-Aguirre, N.$$uUniversidad de Zaragoza
000161006 700__ $$0(orcid)0000-0002-9031-3961$$aPalacios-Gasós, P.$$uUniversidad de Zaragoza
000161006 7102_ $$11013$$2090$$aUniversidad de Zaragoza$$bDpto. Cirugía$$cÁrea Cirugía
000161006 773__ $$g(2025), [10 pp.]$$tUpdates in Surgery$$x2038-131X
000161006 8564_ $$s222232$$uhttps://zaguan.unizar.es/record/161006/files/texto_completo.pdf$$yPostprint$$zinfo:eu-repo/date/embargoEnd/2026-05-14
000161006 8564_ $$s1812219$$uhttps://zaguan.unizar.es/record/161006/files/texto_completo.jpg?subformat=icon$$xicon$$yPostprint$$zinfo:eu-repo/date/embargoEnd/2026-05-14
000161006 909CO $$ooai:zaguan.unizar.es:161006$$particulos$$pdriver
000161006 951__ $$a2025-10-17-14:32:57
000161006 980__ $$aARTICLE