In the April issue of Archives, Ishizawa et al1 reported on the clinical use of indocyanine green (ICG) fluorescent cholangiography in a case of laparoscopic cholecystectomy (LC). A 2.5-mg intravenous dose of ICG given 2 hours before surgery defined the biliary anatomy by fluorescent imaging.
The laparoscopic fluorescent intraoperative ICG cholangiography proved safe and efficient in identifying the cystic and common hepatic ducts within the hepatoduodenal ligament. Although the experience is limited to a single case, Ishizawa et al are justified in emphasizing the merits of uninterrupted cholangiographic imaging, avoidance of ionizing radiation, and potential bile duct injury (BDI) during transcystic insertion of the cholangio catheter.