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
- Preoperative administration of ICG,
- Exposure of the hepatoduodenal ligament,
- Initial anatomical evaluation,
- Identification of the cystic duct and common bile duct junction,
- Identification of the cystic duct and its junction to the gallbladder,
- Identification of the Common Hepatic Duct,
- Identification of the common bile duct,
- Identification of cystic artery and optional performance of arteriography
- Time‑out before transection and re‑identification of Calot’s triangle structures
- 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.