eP277 Early Experience of Indocyanine Green Fluorescence Imaging in Laparoscopic Cholecystectomy: The First Use in a District General Hospital in Northern Ireland

Aim This study aims to evaluate the feasibility, safety, and effectiveness of Indocyanine Green Fluorescence Imaging (ICG-FL) as a novel, real-time, and radiation technique for biliary anatomy identification during laparoscopic cholecystectomy. Methods A total of 5 patients (2 females, 3 males) with a mean age of 63.6 years (range: 45–74) underwent LC with ICG-FI. All patients had Charlson comorbidity index grade 1. Indications included calculus cholecystitis (80%) and gallstone pancreatitis (20%). ICG was administered preoperatively, and the time to biliary anatomy visualization and intraoperative outcomes were recorded. Results ICG-FI facilitated biliary visualization in all cases, with a mean administration-to-visualization time of 90 minutes. The critical view of safety (CVS) was achieved in 80% of cases. Operative challenges were encountered in two patients due to adhesions, requiring extended operative times of 118 and 150 minutes. The median operative time was 114 minutes (range: 70–150). No conversions to open surgery or iatrogenic injuries were reported. ICG-FI eliminated the need for intraoperative cholangiography, thus avoiding radiation exposure. The average hospital stay was 2.4 days (range: 1–5), with no postoperative complications. Conclusion ICG-FI proved to be a valuable adjunct for biliary visualization during LC, particularly in challenging cases. It demonstrated a safe and efficient alternative to intraoperative cholangiography, enhancing surgeon confidence and workflow integration. Further studies with larger cohorts are warranted to validate these findings and assess the impact on surgical learning curves.