Robotic-assisted laparoscopic cholecystectomy with indocyanine green fluorescent cholangiography and intraoperative cholangiogram for patients with acute and chronic cholecystitis: a case series

Indocyanine green fluorescent cholangiography (ICG) and intraoperative cholangiography (IOC) are both useful during cholecystectomy. Laparoscopic cholecystectomy with IOC is commonly performed in various situations; however, there have been concerns with performing IOC during robotic cholecystectomy such as operating room set up and increased operative time due to docking and undocking of the robot. We argue if IOC is readily available and is possible, safe, and not extremely time consuming, that it should be utilized in conjunction with indocyanine green fluorescent cholangiography, instead of preoperative magnetic resonance cholangiopancreatography (MRCP). This could potentially decrease overall cost and the hospital length of stay. We report our experience with ten cases and describe our operative technique.