P11: NEAR INFRARED FLUORESCENT CHOLANGIOGRAPHY IN LAPAROSCOPIC CHOLECYSTECTOMY: A SINGLE CENTRE FEASIBILITY STUDY. THE OPTIMUM DOSING REGIME, LIMITATIONS AND WHERE NEXT?

Abstract Introduction This study explored near-infrared fluorescent cholangiography (NIRFC) with Indocyanine Green (ICG) during laparoscopic cholecystectomy (LC) surgery in a tertiary referral hepatobiliary unit. ICG binds to albumin and is excreted bile. NIRFC utilises the excretory properties of provide dynamic extrahepatic bile duct mapping LC. Method Non-randomised single centre feasibility study. Twenty-two participants were sequentially allocated four dosing subgroups prior assisted Each received intravenous dose LC Stryker Novadaq NIR laparoscope. The biliary anatomy was assessed at three time-points, detection compared radiological cholangiogram where available surgeon satisfaction assessed. Result Eight 2.5mg 20-40min before surgery, 0.25mg/kg 20-40min, five 90min – 180min 12 36 hour pre-operatively. Average age 50 years (S.D±15), BMI 27.5m2 (S.D±3.6), 6/22 acute procedures. prolonged interval produced increased structure identification (p = 0.016), reduced noise signal ratio consistently preferred by operating surgeon. inferior (n 10) 0.014) for mapping. We observed iatrogenic spillage saturating field obscuring differentiation peri-hilar inflammation impeding Conclusion regimen hours provides optimum visualisation. Fluorescent tissue penetrance limited inflammation. More research efficiency emergency required. Take-home message An extra-hepatic structures near infrared cholangiography. role remains ill-defined.