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The purpose of this prospective, randomized, exploratory clinical trial was to optimize the dose and dosing time of ICG.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>PubMed was searched to determine the optimal dose. To optimize the dosing time of ICG, a clinical trial was designed with two parts. The first part included patients with T tubes for more than 1\u00a0month. After the patient was injected with ICG, bile was collected at 10 time points to explore the change and trends of bile fluorescence intensity (FI). In addition, the results of the first experiment were used to setup a randomized controlled trial (RCT) that aimed to find the optimal dosing timing for ICG injections for laparoscopic cholecystectomy (LC). During surgery, imaging data were collected for analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>After performing a systematic review, the ICG injection dose for each patient in the clinical trial was 10\u00a0mg. Five patients were included in the first part of the study. Bile collected 8\u00a0h after ICG injection had a higher FI than bile collected at other time points (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05), and the FI of bile collected 20\u00a0h after ICG injection was nearly zero. In the second part of the experiment, 4 groups of patients (6 patients per group) were injected with 10\u00a0mg ICG at 8, 10, 12 and 14\u00a0h prior to surgery. The distribution of bile duct FI (<jats:italic>p<\/jats:italic>\u2009=\u20090.001), liver FI (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), and common bile duct (CBD)-to-liver contrast (<jats:italic>p<\/jats:italic>\u2009=\u20090.001) were not the same in each group. Further analysis with the Bonferroni method revealed the following: (1) the FI of the CBD in the 8\u00a0h group was significantly different from that in the 14\u00a0h group (adjusted<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001); (2) the liver FI of the 8\u00a0h group was higher than that of the 10\u00a0h group (adjusted<jats:italic>p<\/jats:italic>\u2009=\u20090.042) and the 14\u00a0h group (adjusted<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001); and (3) the CBD-to-liver contrast of the 8\u00a0h group was lower than that of the 10\u00a0h group (adjusted<jats:italic>p<\/jats:italic>\u2009=\u20090.013) and the 14\u00a0h group (adjusted<jats:italic>p<\/jats:italic>\u2009=\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>ICG FC enables the real-time identification of extrahepatic bile ducts. The optimal effect of FC can be achieved by performing 10\u00a0mg ICG injections 10 to 12\u00a0h prior to surgery.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00464-020-08058-6","type":"journal-article","created":{"date-parts":[[2020,10,7]],"date-time":"2020-10-07T15:03:09Z","timestamp":1602082989000},"page":"5573-5582","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":47,"title":["Extrahepatic biliary tract visualization using near-infrared fluorescence imaging with indocyanine green: optimization of dose and dosing time"],"prefix":"10.1007","volume":"35","author":[{"given":"Qiangxing","family":"Chen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rou","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiefeng","family":"Weng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yueyuan","family":"Lai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiao","family":"Kuang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuai","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhaofeng","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8440-519X","authenticated-orcid":false,"given":"Weili","family":"Gu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,10,7]]},"reference":[{"key":"8058_CR1","doi-asserted-by":"publisher","first-page":"1018","DOI":"10.1001\/jama.1993.03500080066034","volume":"269","author":"J Gollan","year":"1993","unstructured":"Gollan J, Bulkley PL, Diehl A (1993) NIH Consensus conference. 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