Copyright ©The Author(s) 2021.
World J Gastroenterol. Sep 28, 2021; 27(36): 5989-6003
Published online Sep 28, 2021. doi: 10.3748/wjg.v27.i36.5989
Table 1 Cholecysto-cholangiography with direct intra-gallbladder indocyanine green injection
Type of publication
No. of patients
No. of patients with gallbladder lithiasis
No. of patients with acute cholecystitis
Conversion to open surgery
Jao et al[26], 2020Case series202 2 trans-PTGBD casesLymphatic spillage0
Nitta et al[24], 2020Case report1011 case through DGBP-0
Škrabecet al[23], 2020Case-controlled study2019120 cases through DGBPICG bile leakage in 1 case; No progression of dye into the CD in 3 cases1
Liu et al[22], 2017Cohort study46212518 trans-PTGBD cases; 28 cases through DGBPICG leakage in 5 cases0
Graves et al[25], 2017Cohort study119211 cases through DGBPNo progression of dye into the CD in 1 case0
Table 2 Fluorescent cholangiography in patients with acute cholecystitis
Type of publication
No. of patients
Agnus et al[17], 2020Euro-FIGS registryLC58
Dip et al[32], 2020RCTLC44
Di Maggio et al[30], 2020Prospective cohort studyLC16
Daskalaki et al[31], 2014Retrospective cohort studyRC24
Yoshiya et al[33], 2019Retrospective cohort studyLC after-PTGBD130
Table 3 Recruiting randomized controlled trials using indocyanine green fluorescence cholangiography
Study coordinator; NCT No.Participating countryNo. of patientsPeriod studyPublished dataMain outcomeControlled groupDose indocyanine green Dosing timeConversion to open surgeryBile duct injury
Dip et al[32]; NCT 02702843United States639April 2016Ann Surg 2020Identification of biliary anatomyWhite light0.05 mg/kg> 45 min prior to surgeryOne patient for bleedingNo
Lehrskov et al[50]; NCT 02344654Denmark120March 2015-August 2018Br J Surg 2020Visualization of the critical junction Intraoperative cholangiogram0.05 mg/kgAfter intubationNoNo
van den Bos et al[61]; NCT 02558556The Netherlands308January 2016OngoingTime to achieve critical view of safetyWhite light2.5 mgAfter intubationNANA
Koong et al[60] ; NCT04228835Malaysia63March2017-July 2019Asian J Surg 2021Time to achieve critical view of safetyWhite light2.5 mgBefore induction of anesthesiaNoNo
Table 4 Advantages and current limitations of fluorescent cholangiography in comparison to intraoperative cholangiogram and laparoscopic ultrasonography
Real-time visualization of biliary anatomy in elective and emergent settingsLimited in patients with specific conditions, such as overweight and obesity; it needs a preliminary dissection and exposure of the hepatocystic triangle
Safer dissection of the hepatocystic triangleLimited scientific evidence in the setting of acute cholecystitis
Detection of biliary variants and biliary leaksHigh variability about indocyanine green dose and dosing time
Implementing method in combination with adequate dissection and identification technique to achieve critical view of safetyDetection of bile duct stones
Feasibility and safetyNeed for consensus conference and international guidelines
Reduced medical costs
Lack of X-ray exposure
Simplicity and lack of learning curve
Teaching tool for young surgeons
Possibility to associate fluorescent angiography
Strong potential to become a gold standard during all cholecystectomies
Table 5 Studies reporting robotic cholecystectomy and near-infrared fluorescent cholangiography
Type of publication
No. of patients
Incidence of conversion rate to open surgery (%)
Sharma et al[72], 2017Retrospective cohort study96RC2.1
Gangemi et al[73], 2017Retrospective cohort study676RC0.15
Maker et al[71], 2017Cohort study35RCNR
Daskalaki et al[31], 2014Retrospective cohort study184RC0.00
Spinoglio et al[70], 2013Cohort study45SIRC0.00
Buchs et al[55], 2013Cohort study23SIRC0.00
Buchs et al[69], 2012Prospective cohort study12SIRC0.00