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- Title
Fluorescent incisionless cholangiography as a teaching tool for identification of Calot's triangle.
- Authors
Roy, Mayank; Dip, Fernando; Nguyen, David; Simpfendorfer, Conrad; Menzo, Emanuele; Szomstein, Samuel; Rosenthal, Raul; Simpfendorfer, Conrad H; Menzo, Emanuele Lo; Rosenthal, Raul J
- Abstract
<bold>Background: </bold>Intraoperative incisionless fluorescent cholangiogram (IOIFC) has been demonstrated to be a useful tool to increase the visualization of Calot's triangle. This study evaluates the identification of extrahepatic biliary structures with IOIFC by medical students and surgery residents.<bold>Methods: </bold>Two pictures were taken, one with xenon light and one with near-infrared (NIR) light, at the same stage during dissection of Calot's triangle in ten different cases of laparoscopic cholecystectomy (LC). All twenty pictures were organized in a random fashion to remove any imagery bias. Twenty students and twenty residents were asked to identify the biliary anatomy.<bold>Results: </bold>Medical students were able to accurately identify the cystic duct on an average 33.8 % under the xenon light versus 86 % under NIR light (p = 0.0001), the common hepatic duct (CHD) on an average 19 % under the xenon light versus 88.5 % under NIR light (p = 0.0001), and the junction on an average 24 % under xenon light versus 80.5 % under NIR light (p = 0.0001). Surgery residents were able to accurately identify the cystic duct on an average 40 % under the xenon light versus 99 % under NIR light (p = 0.0001), the CHD on an average 35 % under the xenon light versus 96 % under NIR light (p = 0.0001), and the junction on an average 24 % under the xenon light versus 95.5 % under NIR light (p = 0.0001).<bold>Conclusions: </bold>IOIFC increases the visualization of Calot's triangle structures when compared to xenon light. IOIFC may be a useful teaching tool in residency programs to teach LC.
- Subjects
CHOLANGIOGRAPHY; INTRAOPERATIVE care; TRAINING of medical residents; MEDICAL photography; BILE ducts; INDOCYANINE green; WOUNDS &; injuries; THERAPEUTICS; PREVENTION of medical errors; ARTERIES; BILE duct diseases; CHOLECYSTECTOMY; DIAGNOSTIC imaging; DYES &; dyeing; FLUOROSCOPY; GASES; LAPAROSCOPIC surgery; LIGHTING
- Publication
Surgical Endoscopy & Other Interventional Techniques, 2017, Vol 31, Issue 6, p2483
- ISSN
1866-6817
- Publication type
journal article
- DOI
10.1007/s00464-016-5250-x