Use of a fluorescent bile acid to enhance visualization of the biliary tract and bile leaks during laparoscopic surgery in rabbits

Background: We set out to determine whether intravenously administered chol ylglycylaminofluorescein (CGF), a fluorescent bile acid, would enhance the Visualization of the biliary tract and bile leaks in rabbits undergoing lap aroscopic cholecystectomy (LC). Methods: CGF was infused at doses of 1, 5, and 10 mg/kg b.w. Biliary recove ry was determined spectrophotometrically (six rabbits), For LC (seven rabbi ts), a blue (fluorescein) filter was attached to the light source, and a fl uorescein-emission filter was attached to the charge coupled device (CCD) c amera. The biliary tract and bile leak (made by incising the gallbladder) w as observed under standard and fluorescent illumination. Results: Apple-green fluorescence appeared in 2 min and persisted for 30-60 min, enhancing visualization of bile duct anatomy as well as the bile leak . Biliary recovery of CGF at 90 min was high (86-96% of the infused dose). Conclusion: In rabbits, CGF is secreted quantitatively in bile, induces bil iary fluorescence, and enhances visualization of the bile ducts and bile le aks when viewed with appropriate filters.