2019 Volume 52 Issue 1 Pages 76-82
We performed laparoscopic deroofing of hepatic cysts aided by indocyanine green (ICG) fluorescence imaging in 6 patients. All patients were women: average age 63 (52–82), average duration of surgery 152.3 min (103–232), average blood loss 14.6 ml (1–70), no perioperative complications. In no patient was cyst fluid fluorescent by ICG imaging in any patient at laparotomy. When the cyst wall was opened and the interior wall was examined after fluid aspiration, the biliary ducts, which had been invisible under white light, were sharply delineated. Visible ducts relevant to the incision line were clipped or ligated, and resected. The coagulable area of the remaining internal wall was extremely small, and was localized to avoid visible vessels and delineated ducts. This method contributes to a safer laparoscopic deroofing procedure by enabling identification of any bile leakage from the transected liver surface and the assessment of duct paths in the internal wall of the cyst.
