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Fluorescence Cholangiography During Cholecystectomy - a RCT

Not Applicable
Completed
Conditions
Gallstones
Cholecystitis
Interventions
Drug: Urografin
Device: Near-infrared illumination
Radiation: X-ray
Registration Number
NCT02344654
Lead Sponsor
Hvidovre University Hospital
Brief Summary

The primary objective is to compare the success rates of intraoperative fluorescent cholangiography using indocyanine green versus conventional X-ray cholangiography for the identification of bile duct anatomy during laparoscopic cholecystectomy for complicated gallstone disease in a randomized design with 120 patients.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
120
Inclusion Criteria
  • Patient scheduled for planned laparoscopic cholecystectomy by one surgeon
  • Complicated gallstone disease
Exclusion Criteria
  • Open cholecystectomy
  • Allergy towards iodine, urografin or indocyanine green
  • Liver or renal insufficiency
  • Thyrotoxicosis
  • Pregnancy or lactation
  • Legally incompetent for any reason
  • Withdrawal of inclusion consent at any time

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Fluorescence cholangiographyIndocyanine greenAfter induction of anaesthesia 2.5-7.5 mg of indocyanine green (0.05 mg/kg) is injected intravenously. The operation field is routinely inspected in the fluorescence imaging mode before dissection of Calot´s triangle. During dissection, the fluorescence imaging mode is used when needed, before division of any tubular structure and after division of the cystic duct and artery.
Fluorescence cholangiographyNear-infrared illuminationAfter induction of anaesthesia 2.5-7.5 mg of indocyanine green (0.05 mg/kg) is injected intravenously. The operation field is routinely inspected in the fluorescence imaging mode before dissection of Calot´s triangle. During dissection, the fluorescence imaging mode is used when needed, before division of any tubular structure and after division of the cystic duct and artery.
X-ray cholangiographyUrografinThe cholangiography is performed after dissection of the cystic duct by cannulation of the cystic duct with a catheter using either a Kumar- or Olsen grasper. A mobile X-ray C-arm system is used, and the monochrome X-ray image is shown on a separate screen. After satisfactory identification of the extra-hepatic biliary ducts, the intraoperative cholangiography is discontinued and the gallbladder is removed in a standardized manner.
X-ray cholangiographyX-rayThe cholangiography is performed after dissection of the cystic duct by cannulation of the cystic duct with a catheter using either a Kumar- or Olsen grasper. A mobile X-ray C-arm system is used, and the monochrome X-ray image is shown on a separate screen. After satisfactory identification of the extra-hepatic biliary ducts, the intraoperative cholangiography is discontinued and the gallbladder is removed in a standardized manner.
Primary Outcome Measures
NameTimeMethod
Visualization of the cystic duct - common hepatic duct - common bile duct junctionIntraoperative
Secondary Outcome Measures
NameTimeMethod
Surgeon satisfaction score (Measured on a 5 point VAS scale)Intraoperative

Measured on a 5 point VAS scale

Per-/postoperative adverse events as a measure of safety and tolerabilityIntraoperative
Time spend for intraoperative fluorescent cholangiography/conventional X-ray cholangiographyIntraoperative
Total cost of operation incl fluorescent/conventional X-ray cholangiographyAdmission to discharge from hospital (0-30 days)
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