{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T12:06:01Z","timestamp":1777637161008,"version":"3.51.4"},"reference-count":17,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,5,30]],"date-time":"2021-05-30T00:00:00Z","timestamp":1622332800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Asian J Endoscop Surgery"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>For patients who have acute severe cholecystitis, urgent\/early biliary drainage followed by delayed\/elective laparoscopic cholecystectomy is recommended according to the Tokyo Guidelines 2018. Percutaneous transhepatic gallbladder drainage is an established technique. Recently, transmural gallbladder drainage under the guidance of endoscopic ultrasonography (EUS\u2010GBD) was reported as a safe alternative. During surgery, fluorescence imaging using indocyanine green (ICG) has been increasingly used for visualizing the bile ducts. Herein, we report a sequential treatment approach which ensures safety without impairing normal activities before cholecystectomy: EUS\u2010GBD followed by laparoscopic cholecystectomy using ICG fluorescence imaging.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Surgical Technique<\/jats:title><jats:p>A 66\u2010year\u2010old man with acute cholecystitis underwent urgent EUS\u2010GBD and had the drainage tube placement through the duodenum into the gallbladder. During 2.5\u00a0months of the waiting period, he had no clinical troubles. After insertion of a laparoscope, we found a structure between the gallbladder and the duodenum. We injected 0.025\u2009mg\/mL of ICG into the nasobiliary drainage tube (placed in the gallbladder through the duodenum) and confirmed that the structure was a fistula. After removing the tube, the fistula was divided using a surgical stapler under the guidance of fluorescence imaging. The cystic and common bile ducts were also clearly visualized as fluorescence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>We reported a safe sequential treatment approach for the patient who required biliary drainage: EUS\u2010GBD followed by laparoscopic cholecystectomy under the guidance of ICG fluorescence imaging. This sequential approach may improve patients' satisfaction with respect to quality of life during the waiting period and may ensure the safety of laparoscopic cholecystectomy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ases.12955","type":"journal-article","created":{"date-parts":[[2021,5,31]],"date-time":"2021-05-31T04:41:36Z","timestamp":1622436096000},"page":"230-234","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["A safe sequential treatment approach for patients who have acute cholecystitis with severe inflammation: Transmural gallbladder drainage followed by laparoscopic cholecystectomy under the guidance of fluorescence imaging"],"prefix":"10.1111","volume":"15","author":[{"given":"Yuri","family":"Okada","sequence":"first","affiliation":[{"name":"Hepato\u2010Biliary\u2010Pancreatic Surgery Division, Department of Surgery Graduate School of Medicine, the University of Tokyo  Tokyo 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