{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T15:48:52Z","timestamp":1792165732230,"version":"4.4.0"},"reference-count":10,"publisher":"Ovid Technologies (Wolters Kluwer Health)","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Bile duct injury during laparoscopic cholecystectomy (LC) remains an uncommon but serious complication, especially in the presence of inflammation and distorted biliary anatomy. Reported injury rates range from 0.26% to 0.7%, with conversion-to-open rates of 2.6%\u201310% when the critical view of safety (CVS) cannot be achieved. Indocyanine green fluorescence (ICG-F) imaging has been introduced to improve real-time biliary visualization. This study evaluates its role in complicated gallbladder disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      This prospective comparative study included 80 patients undergoing LC between May 2024 and October 2025. Patients were divided into ICG-assisted LC (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 40) and conventional LC (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 40). Difficulty was assessed using Nassar and Sugrue grading systems. Primary outcomes were time to biliary identification and total operative duration. Secondary outcomes included conversion rate, complications, hospital stay, and surgeon satisfaction.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Baseline characteristics were comparable (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &gt; 0.05). The ICG group had significantly shorter time to CVS identification (19.6 \u00b1 5.36 vs. 35.5 \u00b1 5.10 minutes) and total operative time (49.1 \u00b1 11.20 vs. 80.2 \u00b1 9.79 minutes;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.05). Conversion occurred in four conventional cases and none in the ICG group (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.220). Surgeon satisfaction was higher with ICG (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). Hospital stay was shorter but not significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>ICG-F cholangiography facilitates earlier biliary identification and reduces operative time in difficult LC. Larger multicentre randomized studies are required to confirm its impact on conversion rates and clinical outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jmas.jmas_233_26","type":"journal-article","created":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T15:00:33Z","timestamp":1792162833000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Role of indocyanine green fluorescence cholangiography in laparoscopic cholecystectomy for complicated gall bladder disease: A prospective comparative study"],"prefix":"10.4103","author":[{"given":"M. Praveen","family":"Kumar","sequence":"first","affiliation":[{"name":"Department of General Surgery, Sagar Hospital, Bengaluru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Niranjan","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Sagar Hospital, Bengaluru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. R.","family":"Ravishankar","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Sagar Hospital, Bengaluru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Lakshman","sequence":"additional","affiliation":[{"name":"Shanthi Hospital and Research Centre, Bengaluru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nishanth","family":"Lakshmikantha","sequence":"additional","affiliation":[{"name":"Shanthi Hospital and Research Centre, Bengaluru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aeiman","family":"Saniya","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Sagar Hospital, Bengaluru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nithya","family":"Ravichandran","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Sagar Hospital, Bengaluru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,10,15]]},"reference":[{"key":"R1-20261016","doi-asserted-by":"crossref","first-page":"2175","DOI":"10.1007\/s00464-017-5974-2","article-title":"Outcome trends and safety measures after 30 years of laparoscopic cholecystectomy: A systematic review and pooled data analysis","volume":"32","author":"Pucher","year":"2018","journal-title":"Surg Endosc"},{"key":"R2-20261016","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1002\/bjs.7335","article-title":"Bile duct injury and use of cholangiography during laparoscopic cholecystectomy","volume":"98","author":"Giger","year":"2011","journal-title":"Br J Surg"},{"key":"R3-20261016","doi-asserted-by":"crossref","first-page":"2731","DOI":"10.1007\/s00464-016-5318-7","article-title":"Biliary tract visualization using near-infrared imaging with indocyanine green during laparoscopic cholecystectomy: Results of a systematic 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system","volume":"10","author":"Sugrue","year":"2015","journal-title":"World J Emerg Surg"},{"key":"R7-20261016","doi-asserted-by":"crossref","first-page":"5729","DOI":"10.1007\/s00464-020-08045-x","article-title":"Fluorescent cholangiography significantly improves patient outcomes for laparoscopic cholecystectomy","volume":"35","author":"Broderick","year":"2021","journal-title":"Surg Endosc"},{"key":"R8-20261016","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1007\/s00268-018-4760-1","article-title":"Usability of intraoperative fluorescence imaging with indocyanine green during laparoscopic cholecystectomy after percutaneous transhepatic gallbladder drainage","volume":"43","author":"Yoshiya","year":"2019","journal-title":"World J Surg"},{"key":"R9-20261016","doi-asserted-by":"crossref","first-page":"1959","DOI":"10.1007\/s00464-019-06970-0","article-title":"Routine near infra-red indocyanine green fluorescent cholangiography versus intraoperative cholangiography during laparoscopic cholecystectomy: A case-matched comparison","volume":"34","author":"Quaresima","year":"2020","journal-title":"Surg Endosc"},{"key":"R10-20261016","doi-asserted-by":"crossref","first-page":"187","DOI":"10.3892\/etm.2021.11110","article-title":"Systematic review of the role of indocyanine green near-infrared fluorescence in safe laparoscopic cholecystectomy (Review)","volume":"23","author":"Serban","year":"2022","journal-title":"Exp Ther Med"}],"container-title":["Journal of Minimal Access 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