Evaluation of the efficacy of fluorescent visualization of bile ducts using fluorescein and ultraviolet light at laparoscopic cholecystectomy / Ahmed Amr Abdalla Mohsen ; Supervised Mahmoud Saber Elbasiouny , Mostafa Elshazli , Osama Azmy

Thesis (Ph.D.) - Cairo University - National Institute of Laser Enhanced Science - Department of Laser Application in Medical and Biological

Ultraviolet/fluorescein technology is not new. The new additions for this technology are the use of the commercially available fluorescein sodium, its application in humans for intraoperative mapping of bile ducts, and the development of a sterilizable good conduction device that can transmit a calculated dose of energy to the tissues at laparoscopic surgery. The technology and device were tested for diagnostic accuracy, i.e., ability to see fluorescent bile ducts prior to their conventional anatomical localization by dissection. Specificity was 100%. The fluorescence technique is, therefore, highly reliable when fluorescent ducts were seen. Sensitivity was 82.5%, which means that sometimes bile ducts cannot be seen by the fluorescence technique before their conventional anatomical localization by dissection. The cause might be thickening of overlying tissues. The technique is theoretically safe. In this limited study there were no complications related to its application. The device is inexpensive in comparison with other methods. Its running cost (fluorescein sodium) is minimal. The technique is simple to use and requires no sophisticated setting up or special precautions. Technical improvements are required to improve sensitivity of the technique. Wider research is required to assess its direct impact on bile duct injuries

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