Palomba Giuseppe, Dinuzzi Vincenza Paola, Sorrentino Giuseppe, Capuano Marianna, Basile Raffaele, Impero Stefania, Pegoraro Francesca, De Palma Giovanni Domenico, Aprea Giovanni
Ann Ital Chir. 2022 Nov 24;11:S2239253X2203818X.
Cholangiography with indocyanine green fluorescence (ICG) is increasingly used to visualize the bile duct anatomy during laparoscopic cholecystectomy. Biliary leaks are rare complications after laparoscopic cholecystectomy, result could be lethal. Lesion's site is not always visible. We present an interesting case of a patient with biloma due to an iatrogenic lesion of the biliary tract, treated in urgency using ICG fluorescence. To our knowledge, this is the only case in the literature.
A 62-years-old patient after 7 days from laparoscopic cholecystectomy presented abdominal pain and fever. Blood tests showed an increase of inflammation indexes. Abdominal US and abdominal CT revealed a conspicuous right sub-hepatic fluid. We performed a laparoscopy using ICG fluorescence to find the biliary leak. Operative time of surgery was 60 min. There were no complications during this procedure.
ICG is a safe and effective procedure that enables real-time visualization of the biliary system. In some cases, it can also be used in urgent surgery, where the biliary anatomy is much more complex.
Biloma, Indocyanine green fluorescence, Iatrogenic biliary leaks, Urgent surgery.
吲哚菁绿荧光胆管造影术（ICG）在腹腔镜胆囊切除术中越来越多地用于显示胆管解剖结构。胆漏是腹腔镜胆囊切除术后罕见的并发症，后果可能是致命的。病变部位并不总是可见的。我们报告一例因医源性胆道损伤导致胆汁瘤的患者，紧急采用ICG荧光进行治疗。据我们所知，这是文献中唯一的病例。
一名62岁患者在腹腔镜胆囊切除术后7天出现腹痛和发热。血液检查显示炎症指标升高。腹部超声和腹部CT显示肝右下有明显积液。我们使用ICG荧光进行腹腔镜检查以发现胆漏。手术时间为60分钟。在此过程中无并发症发生。
ICG是一种安全有效的方法，能够实时显示胆道系统。在某些情况下，它也可用于胆道解剖结构更为复杂急迫手术中。
胆汁瘤；吲哚菁绿荧光；医源性胆漏；急诊手术
