The purpose of this study was to describe the most important steps in the performance of Near-infrared fluorescent cholangiography (NIFC).

The ten steps identified as critical when performing NIFC during LC are

  1. Preoperative administration of ICG,
  2. Exposure of the hepatoduodenal ligament,
  3. Initial anatomical evaluation,
  4. Identification of the cystic duct and common bile duct junction,
  5. Identification of the cystic duct and its junction to the gallbladder,
  6. Identification of the Common Hepatic Duct,
  7. Identification of the common bile duct,
  8. Identification of cystic artery and optional performance of arteriography 
  9. Timeā€‘out before transection and reā€‘identification of Calotā€™s triangle structures
  10. Evaluation of liver bed and identification of accessory ducts

Conclusions: Routine use of NIFC is a useful diagnostic tool to better visualize the extrahepatic biliary structures during LC. The implementation of specific standardized steps might provide the surgeon with a better algorithm to use this technology and consequently reduce the incidence of BDI.

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