How low can you go? Intraoperative microdosing of indocyanine green for fluorescence cholangiography during laparoscopic cholecystectomy.
Surgical endoscopy October 1, 2025 Ryan C Broderick, Graham J Spurzem, Ana Garcia Cabrera et al.
A microdose (0.5 mg) of indocyanine green given intravenously at anesthesia induction provides excellent biliary visualization during laparoscopic cholecystectomy, comparable to a standard 7.5 mg dose given 60-120 minutes preoperatively. In a review of 100 patients (50 per group), the cystic duct was seen before dissection in 86% of microdose cases versus 88% of standard cases, and the common bile duct and common hepatic duct were seen in all cases in both groups. Signal strength, clarity, and clinical usefulness scores were nearly identical between groups. The intraoperative microdose protocol eliminates the need for preoperative ICG administration, streamlining perioperative workflows.