2026 Volume 40 Issue 2 Pages 218-222
Laparoscopic cholecystectomy (LC) is the most commonly performed minimally invasive surgery in Japan. Although technological advances have enabled highly precise surgical techniques, bile duct injury still occurs, mainly due to intraoperative misidentification of biliary anatomy. Indocyanine green (ICG) fluorescence cholangiography provides simple and highly sensitive visualization of the extrahepatic bile ducts and has been established as an intraoperative navigation tool covered by the national health insurance system in Japan. However, further innovative technologies are required to more effectively prevent bile duct injury. Our department has been actively developing intraoperative navigation surgery that integrates ICG fluorescence imaging with rapidly evolving artificial intelligence (AI)-based anatomical recognition to achieve safer and more accurate LC. This article reviews the clinical utility of ICG fluorescence cholangiography and proposes a next-generation concept of LC incorporating AI-assisted navigation.
