{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T03:41:06Z","timestamp":1792813266838,"version":"4.5.0"},"reference-count":19,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T00:00:00Z","timestamp":1786320000000},"content-version":"vor","delay-in-days":221,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["23K15507"],"award-info":[{"award-number":["23K15507"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Asian J Endoscop Surgery"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Intraoperative indocyanine green fluorescence is useful in laparoscopic cholecystectomy (Lap\u2010C). The objective of this study was to identify clinical situations in which fluorescence cholangiography is advantageous.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively reviewed intraoperative videos of 64 patients who underwent Lap\u2010C with fluorescence cholangiography and recorded the number of times intraoperative near\u2010infrared mode (NIR\u2010mode) was used. The relationship between the number of times NIRF\u2010mode was used and certain clinical variables was investigated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>NIR\u2010mode was used in a single operation a median of 6 times and a maximum of 25 times. Multivariate analysis revealed that surgical difficulty score (in accordance with the Tokyo Guidelines 2018) was an independent and significant clinical factor affecting the number of times NIR\u2010mode was used, which was significantly correlated with surgical difficulty and operation time. In the high NIR\u2010mode group, surgical difficulty score, operative time, and blood loss were significantly higher compared with the low NIR\u2010mode group; conversion to open surgery, bile duct injury, and postoperative complications were comparable.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Frequent use of fluorescence cholangiography is associated with higher surgical difficulty in Lap\u2010C and may be helpful for avoiding misidentification of biliary anatomy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ases.70360","type":"journal-article","created":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T05:25:19Z","timestamp":1786425919000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Frequent Intraoperative Use of Fluorescence Cholangiography Is Associated With Higher Surgical Difficulty in Laparoscopic Cholecystectomy"],"prefix":"10.1111","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0123-1276","authenticated-orcid":false,"given":"Hironari","family":"Kawai","sequence":"first","affiliation":[{"name":"Department of Digestive Surgery Kawaguchi Municipal Medical Center  Kawaguchi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shunjin","family":"Ryu","sequence":"additional","affiliation":[{"name":"Department of Digestive Surgery Kawaguchi Municipal Medical Center  Kawaguchi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daiki","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Department of Digestive Surgery Kawaguchi Municipal Medical Center  Kawaguchi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyuga","family":"Kawakubo","sequence":"additional","affiliation":[{"name":"Department of Digestive Surgery Kawaguchi Municipal Medical Center  Kawaguchi 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