Routine Use of Indocyanine Green Fluorescence Cholangiography in Cholecystectomy at Marginal Cost and High Dividends: Subvesical Duct Identified

Subvesical ducts are a common source of post-cholecystectomy bile leaks. These ducts typically run along the gallbladder (GB) bed and drain into the right hepatic duct or the common hepatic duct. Identifying these and other morbid anatomical structures at the time of routine cholecystectomy for safe surgery, the use of indocyanine green fluorescence (ICGF) is highly recommended. This case demonstrates the identification of the subvesical bile duct during dissection, which prevented inadvertent injury and bile leakage. While this was an incidental case, it serves as the basis for our argument that ICGF should be routinely used in high-volume centres. After the initial capital investment, the running costs are low. A cost-benefit analysis should be conducted regarding the routine use of ICGF in high-volume hepato-biliary and cholecystectomy performing units.