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Purpose <p>Indocyanine green (ICG) fluorescence imaging enhances biliary visualization during pediatric laparoscopic cholecystectomy (LC), helping to identify anatomical variants and prevent bile duct injury. Standard pediatric recommendations suggest ICG administration 16–24&#xa0;h preoperatively; however, this may be impractical. This study aims to evaluate the safety and effectiveness of short-interval ICG administration.</p> Methods <p>A prospective single-center study (October 2024–June 2025) included pediatric LC patients receiving intravenous Verdye® preoperatively. Visualization of extrahepatic biliary anatomy was assessed intraoperatively using a 5-point Likert scale, HELPFUL (usefulness), and DISTURBED (liver background interference) scores. Data included indication, ICG timing, operative time, and complications according to the Clavien–Dindo classification (C–D).</p> Results <p>Eleven patients (64% female), median age 14&#xa0;years (IQR 12,7–15,7) and median weight 65,5&#xa0;kg (IQR 46,5–80), were included. Five had BMI &gt; 25&#xa0;kg/m<sup>2</sup>; five (46%) underwent preoperative ERCP. ICG (median dose 0.34&#xa0;mg/kg) was administered a median of 225&#xa0;min before surgery. Median operative time was 65&#xa0;min (IQR 58–68). Median Likert score was 5; HELPFUL 3; DISTURBED 1. No ICG-related or C–D complications occurred.</p> Conclusion <p>Short-interval ICG administration was safe, feasible, and effective in enhancing biliary visualization during pediatric LC. This approach was well-tolerated and provided high-quality imaging without complications.</p>

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Short-interval intravenous indocyanine green administration in pediatric laparoscopic cholecystectomy: a prospective evaluation of visualization and safety

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年8月26日

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  • Vojtech Dotlacil,
  • Eliska Pajerova,
  • Dagmar Sovadinova,
  • Barbora Kucerova,
  • Martin Vyhnanek,
  • Michal Rygl

摘要

Purpose

Indocyanine green (ICG) fluorescence imaging enhances biliary visualization during pediatric laparoscopic cholecystectomy (LC), helping to identify anatomical variants and prevent bile duct injury. Standard pediatric recommendations suggest ICG administration 16–24 h preoperatively; however, this may be impractical. This study aims to evaluate the safety and effectiveness of short-interval ICG administration.

Methods

A prospective single-center study (October 2024–June 2025) included pediatric LC patients receiving intravenous Verdye® preoperatively. Visualization of extrahepatic biliary anatomy was assessed intraoperatively using a 5-point Likert scale, HELPFUL (usefulness), and DISTURBED (liver background interference) scores. Data included indication, ICG timing, operative time, and complications according to the Clavien–Dindo classification (C–D).

Results

Eleven patients (64% female), median age 14 years (IQR 12,7–15,7) and median weight 65,5 kg (IQR 46,5–80), were included. Five had BMI > 25 kg/m2; five (46%) underwent preoperative ERCP. ICG (median dose 0.34 mg/kg) was administered a median of 225 min before surgery. Median operative time was 65 min (IQR 58–68). Median Likert score was 5; HELPFUL 3; DISTURBED 1. No ICG-related or C–D complications occurred.

Conclusion

Short-interval ICG administration was safe, feasible, and effective in enhancing biliary visualization during pediatric LC. This approach was well-tolerated and provided high-quality imaging without complications.