Integrating critical view of safety and indocyanine green cholangiography to enhance safety in laparoscopic cholecystectomy: a retrospective cross-sectional study

Abstract Laparoscopic cholecystectomy (LC) is the standard treatment for gallstone-related diseases, but bile duct injury remains a significant complication. This study investigates the efficacy of integrating the Critical View of Safety (CVS) and Indocyanine Green (ICG) fluorescent cholangiography...

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Main Authors: Anuwat Chartkitchareon, Thawatchai Tullavardhana
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-00991-7
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author Anuwat Chartkitchareon
Thawatchai Tullavardhana
author_facet Anuwat Chartkitchareon
Thawatchai Tullavardhana
author_sort Anuwat Chartkitchareon
collection DOAJ
description Abstract Laparoscopic cholecystectomy (LC) is the standard treatment for gallstone-related diseases, but bile duct injury remains a significant complication. This study investigates the efficacy of integrating the Critical View of Safety (CVS) and Indocyanine Green (ICG) fluorescent cholangiography to prevent bile duct injury. A retrospective study was conducted on 50 patients with cholelithiasis and gallstone-related complications who underwent LC at Srinakharinwirot University from April 2022 to April 2024. ICG (2.5 mg) was administered intravenously 60 min prior to surgery. LC was performed using a near-infrared light source. Statistical analysis included Chi-squared, unpaired t-tests, and logistic regression, with a significance level at p < 0.05. CVS was established in 78% of cases. Most cholecystectomies were complete (88%), no major bile duct injuries were reported. Visualization rates for the common bile duct (100%). Patients with gallbladder inflammation or previous history of ERCP had lower visualization rates, but these differences were not statistically significant. The non-CVS group had significantly longer operative times (75.9 vs. 60.5 min; p < 0.001) and higher rates of incomplete cholecystectomy (54.5% vs. 0%; p < 0.001) than the CVS established group. Integrating CVS and ICG fluorescent cholangiography enhances the safety of LC by improving bile duct visualization and reducing the risk of bile duct injury.
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spelling doaj-art-e305befde11a4d5d841d35165635d95e2025-08-20T04:01:25ZengNature PortfolioScientific Reports2045-23222025-07-011511810.1038/s41598-025-00991-7Integrating critical view of safety and indocyanine green cholangiography to enhance safety in laparoscopic cholecystectomy: a retrospective cross-sectional studyAnuwat Chartkitchareon0Thawatchai Tullavardhana1Department of Surgery, Faculty of Medicine, Srinakharinwirot UniversityDepartment of Surgery, Faculty of Medicine, Srinakharinwirot UniversityAbstract Laparoscopic cholecystectomy (LC) is the standard treatment for gallstone-related diseases, but bile duct injury remains a significant complication. This study investigates the efficacy of integrating the Critical View of Safety (CVS) and Indocyanine Green (ICG) fluorescent cholangiography to prevent bile duct injury. A retrospective study was conducted on 50 patients with cholelithiasis and gallstone-related complications who underwent LC at Srinakharinwirot University from April 2022 to April 2024. ICG (2.5 mg) was administered intravenously 60 min prior to surgery. LC was performed using a near-infrared light source. Statistical analysis included Chi-squared, unpaired t-tests, and logistic regression, with a significance level at p < 0.05. CVS was established in 78% of cases. Most cholecystectomies were complete (88%), no major bile duct injuries were reported. Visualization rates for the common bile duct (100%). Patients with gallbladder inflammation or previous history of ERCP had lower visualization rates, but these differences were not statistically significant. The non-CVS group had significantly longer operative times (75.9 vs. 60.5 min; p < 0.001) and higher rates of incomplete cholecystectomy (54.5% vs. 0%; p < 0.001) than the CVS established group. Integrating CVS and ICG fluorescent cholangiography enhances the safety of LC by improving bile duct visualization and reducing the risk of bile duct injury.https://doi.org/10.1038/s41598-025-00991-7CholelithiasisIndocyanine greenLaparoscopic cholecystectomyPatient safetySurgery
spellingShingle Anuwat Chartkitchareon
Thawatchai Tullavardhana
Integrating critical view of safety and indocyanine green cholangiography to enhance safety in laparoscopic cholecystectomy: a retrospective cross-sectional study
Scientific Reports
Cholelithiasis
Indocyanine green
Laparoscopic cholecystectomy
Patient safety
Surgery
title Integrating critical view of safety and indocyanine green cholangiography to enhance safety in laparoscopic cholecystectomy: a retrospective cross-sectional study
title_full Integrating critical view of safety and indocyanine green cholangiography to enhance safety in laparoscopic cholecystectomy: a retrospective cross-sectional study
title_fullStr Integrating critical view of safety and indocyanine green cholangiography to enhance safety in laparoscopic cholecystectomy: a retrospective cross-sectional study
title_full_unstemmed Integrating critical view of safety and indocyanine green cholangiography to enhance safety in laparoscopic cholecystectomy: a retrospective cross-sectional study
title_short Integrating critical view of safety and indocyanine green cholangiography to enhance safety in laparoscopic cholecystectomy: a retrospective cross-sectional study
title_sort integrating critical view of safety and indocyanine green cholangiography to enhance safety in laparoscopic cholecystectomy a retrospective cross sectional study
topic Cholelithiasis
Indocyanine green
Laparoscopic cholecystectomy
Patient safety
Surgery
url https://doi.org/10.1038/s41598-025-00991-7
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