In rare cases, a patient undergoing cholecystectomy ends up with an incomplete resection of their gallbladder. This can lead to continued pain, infection, and impacted gallstones. The treatment is removal of the residual portion of the gallblader. However, this becomes a very difficult and much higher risk operation due to:
- whatever caused the original operation to fail such as severe inflammation or unusual anatomy
- anytime an area has already been operated on, repeat operation is made more difficult.
In October 2020, I had the opportunity to treat a patient who’s original operation by a surgeon who left town, left him suffering from recurrent gallstone attacks. Besides ongoing pain he requiring repeat endoscopic extractions of the new formed stones. His operation took 3 hours and requiring difficult separation of his duodunum and common bile duct from the gallblader. However, guided by ICG contrast administered by simple IV injection (green in picture above), I was able to remove his entire gallbladder. He was discharged less then 12h after operation, finally able to eat without pain or threat of another attack.
ICG contract is an emergent technology available to help guide surgeons in their dissection.
Dr. Linda Bergal 