Fluorescent cholangiography with direct injection of indocyanine green (ICG) into the gallbladder: a safety method to outline biliary anatomy.

Clara Gené, Fernando Pardo, Francisco Espin, Manel Cremades, Jordi Navinés, Alba Zarate y Esteban Cugat.

A case-controlled study comparing 20 patients undergoing laparoscopic cholecystectomies with Near Infrared Cholangiography (NIRC) with direct injection of ICG into the gallbladder to 20 consecutive standard cholecystectomies. NIRC with direct injection of ICG into the gallbladder is a feasible method that is not time-consuming; it does not require a different learning curve from standard laparoscopic cholecystectomies and has no major complications described so far.

Doctors who have participated

Dr. Pardo

Consultant in Hepatobiliopancreatic Surgery

Dr. Fernando Pardo (Madrid, 1986) is a Digestive surgeon specializing in hepatobiliopancreatic surgery and pancreatic transplantation.

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Dr. Cremades

Consultant in Hepatobiliopancreatic Surgery

Dr. Manel Cremades is a Medical specialist in hepatobiliopancreatic (HPB) surgery and pancreatic transplantation. He is also an Associate Professor at the Faculty of Medicine at the Autonomous University of Barcelona (UAB – Germans Trias Teaching Unit), collaborates on management committees for the implementation of hospital transformation projects, and is the co-founder of two startups in the health sector.

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Dr. Espín

Consultant in Hepatobiliopancreatic Surgery

Dr. Francisco Espín is a  Medical specialist in hepatobiliopancreatic (HPB) surgery and pancreatic transplantation. Associate Professor at the Faculty of Medicine at the Autonomous University of Barcelona (Germans Trias Teaching Unit).

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Dr. Navinés

Consultant in Hepatobiliopancreatic Surgery

Surgeon Specialist in General and Digestive System Surgery and Doctor of Surgery from the Universitat Autònoma de Barcelona.

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Dra. Zárate

Consultant in Hepatobiliopancreatic Surgery

Dr. Alba Zárate (Barcelona, 1989) is a Digestive surgeon specializing in hepatobiliopancreatic surgery and pancreatic transplantation.

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Dr. Cugat

Clinical Head of the Hepatobiliopancreatic Surgery Team

Dr. Esteban Cugat (Barcelona, 1960) is a medical specialist in General and Digestive System Surgery. Specialized in Hepatobiliopancreatic Surgery. Clinical Associate Professor at the Faculty of Medicine of the Autonomous University of Barcelona. 

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Pancreas anastomosis after laparoscopic and robotic pancreatoduodenectomy.

Fernando Pardo, Esteban Cugat, Manel Cremades, Alba Zárate.

A pesar de que a día de hoy la duodenopancreatectomía cefálica laparoscópica y robótica no se realiza en la mayoría de unidades de cirugía hepatobiliopancreática, se trata de una técnica en proyección y que en los próximos años su implementación en determinados casos será incuestionable. La reconstrucción pancreática es una de las partes más demandantes de esta cirugía, y en concreto la anastomosis pancreática. El vídeo muestra la anastomosis pancreático-yeyunal y la anastomosis pancreático-gástrica tanto por laparoscopia como por cirugía robótica. La sistematización del procedimiento permite realizarla de manera segura.

Doctors who have participated

Dr. Pardo

Consultant in Hepatobiliopancreatic Surgery

Dr. Fernando Pardo (Madrid, 1986) is a Digestive surgeon specializing in hepatobiliopancreatic surgery and pancreatic transplantation.

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Dr. Cugat

Clinical Head of the Hepatobiliopancreatic Surgery Team

Dr. Esteban Cugat (Barcelona, 1960) is a medical specialist in General and Digestive System Surgery. Specialized in Hepatobiliopancreatic Surgery. Clinical Associate Professor at the Faculty of Medicine of the Autonomous University of Barcelona. 

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Dr. Cremades

Consultant in Hepatobiliopancreatic Surgery

Dr. Manel Cremades is a Medical specialist in hepatobiliopancreatic (HPB) surgery and pancreatic transplantation. He is also an Associate Professor at the Faculty of Medicine at the Autonomous University of Barcelona (UAB – Germans Trias Teaching Unit), collaborates on management committees for the implementation of hospital transformation projects, and is the co-founder of two startups in the health sector.

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Dra. Zárate

Consultant in Hepatobiliopancreatic Surgery

Dr. Alba Zárate (Barcelona, 1989) is a Digestive surgeon specializing in hepatobiliopancreatic surgery and pancreatic transplantation.

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Dose and administration time of indocyanine green in near-infrared fluorescence cholangiography during laparoscopic cholecystectomy (DOTIG): study protocol for a randomised clinical trial.

Jaime López-Sánchez, Sonsoles Garrosa-Muñoz, Fernando Pardo et al. DOTIG Collaborative Group.

This is a randomised, multicentre, per-protocol analysis, open clinical trial with four arms. The estimated duration of the trial is 12 months. The aim of the study is to analyse whether there are differences between the dose and administration ICG intervals to obtain good-quality near-infrared fluorescence cholangiography with indocyanine green (NIRFC) during laparoscopic cholecystectomy (LC). The primary outcome is the degree of identification of critical biliary structures during LC. In addition, different factors will be analysed that may have an influence on the results of this technique.

This trial was approved by the local institutional Ethics Committee and the AEMPs. The results of the study will be presented to the scientific community through publications, conferences or other means.

Doctors who have participated

Dr. Pardo

Consultant in Hepatobiliopancreatic Surgery

Dr. Fernando Pardo (Madrid, 1986) is a Digestive surgeon specializing in hepatobiliopancreatic surgery and pancreatic transplantation.

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Indocyanine green (ICG) fluorescent cholangiography in laparoscopic cholecystectomy: Simplifying time and dose.

Fernando Pardo, Clara Gené, Jaime López-Sánchez, Alba Zárate, Francisco Espin, Manel Cremades, Jordi Navinés, Christian Herrero, Laura Vidal y Esteban Cugat.

This article aims to analyze and to simplify the optimal dose and time of intravenous indocyanine green (ICG) administration to achieve the identification of the cystic duct and the common bile duct (CBD). The CBD was better visualized in the at induction of anesthesia group (85.4%), in the hours before group (97.1%) (p = 0.002) and in the 1cc group (p = 0.011). When we analyzed the 1 cc group (n = 126) a greater visualization of the CBD was observed in the at induction of anesthesia group (86.7%) and in the hours before group (97.1%) (p = 0.027). Due to its simplicity and reproducibility, we suggest a dose of 2.5 mg administered 2-6 h before the procedure is the optimal. However, ICG administered 30 min prior to the surgery is enough for adequate visualization of biliary structures.

Doctors who have participated

Dr. Pardo

Consultant in Hepatobiliopancreatic Surgery

Dr. Fernando Pardo (Madrid, 1986) is a Digestive surgeon specializing in hepatobiliopancreatic surgery and pancreatic transplantation.

View profile

Dra. Zárate

Consultant in Hepatobiliopancreatic Surgery

Dr. Alba Zárate (Barcelona, 1989) is a Digestive surgeon specializing in hepatobiliopancreatic surgery and pancreatic transplantation.

View profile

Dr. Espín

Consultant in Hepatobiliopancreatic Surgery

Dr. Francisco Espín is a  Medical specialist in hepatobiliopancreatic (HPB) surgery and pancreatic transplantation. Associate Professor at the Faculty of Medicine at the Autonomous University of Barcelona (Germans Trias Teaching Unit).

View profile

Dr. Cremades

Consultant in Hepatobiliopancreatic Surgery

Dr. Manel Cremades is a Medical specialist in hepatobiliopancreatic (HPB) surgery and pancreatic transplantation. He is also an Associate Professor at the Faculty of Medicine at the Autonomous University of Barcelona (UAB – Germans Trias Teaching Unit), collaborates on management committees for the implementation of hospital transformation projects, and is the co-founder of two startups in the health sector.

View profile

Dr. Cugat

Clinical Head of the Hepatobiliopancreatic Surgery Team

Dr. Esteban Cugat (Barcelona, 1960) is a medical specialist in General and Digestive System Surgery. Specialized in Hepatobiliopancreatic Surgery. Clinical Associate Professor at the Faculty of Medicine of the Autonomous University of Barcelona. 

View profile

Dr. Navinés

Consultant in Hepatobiliopancreatic Surgery

Surgeon Specialist in General and Digestive System Surgery and Doctor of Surgery from the Universitat Autònoma de Barcelona.

View profile

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Robotic HBP surgery: a real opportunity with future potential.

Esteban Cugat y Fernando Pardo.

Fragmento de la Editorial: “La figura del mentor, que cumpla con las adecuadas cualidades técnicas, se antoja imprescindible para lograr una formación basada en la calidad quirúrgica y humana y ser el nexo de unión entre una generación de cirujanos que se tuvo que formar en cirugía abierta, en cirugía laparoscópica y ahora en cirugía robótica, con una generación más joven que ya crece paralelamente al mundo de la cirugía robótica”.

Doctors who have participated

Dr. Cugat

Clinical Head of the Hepatobiliopancreatic Surgery Team

Dr. Esteban Cugat (Barcelona, 1960) is a medical specialist in General and Digestive System Surgery. Specialized in Hepatobiliopancreatic Surgery. Clinical Associate Professor at the Faculty of Medicine of the Autonomous University of Barcelona. 

View profile

Dr. Pardo

Consultant in Hepatobiliopancreatic Surgery

Dr. Fernando Pardo (Madrid, 1986) is a Digestive surgeon specializing in hepatobiliopancreatic surgery and pancreatic transplantation.

View profile

Robotic cholecystectomy and transcystic common bile duct exploration with augmented reality glasses and indocyanine green in a patient with a cystic duct cyst.

Fernado Pardo, Laura Vidal, Manel Cremades y Esteban Cugat.

La coledocolitiasis puede ser tratada mediante cirugía mínimamente invasiva en aquellos pacientes con vesícula biliar in situ. Puede realizarse por coledocotomía o a través del conducto cístico, teniendo en cuenta que el acceso transcístico disminuye la morbilidad posoperatoria2. El acceso robótico representa una excelente alternativa y más aún en casos complejos. Se presenta un caso de colecistectomía robótica guiada con verde de indocianina y exploración transcística del colédoco. El cirujano asistente que manejaba el coledocoscopio realizó la intervención guiada con gafas de realidad aumentada. El tiempo operatorio fue de 150 minutos y el paciente fue dado de alta el primer día posoperatorio.

Doctors who have participated

Dr. Cremades

Consultant in Hepatobiliopancreatic Surgery

Dr. Manel Cremades is a Medical specialist in hepatobiliopancreatic (HPB) surgery and pancreatic transplantation. He is also an Associate Professor at the Faculty of Medicine at the Autonomous University of Barcelona (UAB – Germans Trias Teaching Unit), collaborates on management committees for the implementation of hospital transformation projects, and is the co-founder of two startups in the health sector.

View profile

Dr. Cugat

Clinical Head of the Hepatobiliopancreatic Surgery Team

Dr. Esteban Cugat (Barcelona, 1960) is a medical specialist in General and Digestive System Surgery. Specialized in Hepatobiliopancreatic Surgery. Clinical Associate Professor at the Faculty of Medicine of the Autonomous University of Barcelona. 

View profile

Dr. Pardo

Consultant in Hepatobiliopancreatic Surgery

Dr. Fernando Pardo (Madrid, 1986) is a Digestive surgeon specializing in hepatobiliopancreatic surgery and pancreatic transplantation.

View profile

Surgical treatment of the Median Arcuate Ligament Syndrome (MALS) using robotic platform.

Anna Vidal, Alba Zárate, Sara Sentí y Esteban Cugat.

Este síndrome está causado por la compresión extrínseca del tronco celíaco por bandas fibrosas del ligamento arcuato medio. Puede presentar importantes síntomas como dolor abdominal después de las comidas, vómitos y pérdida de peso.

Es este vídeo, elegido vídeo del mes por la revista Cirugía Española, se muestra en detalle el tratamiento quirúrgico mediante abordaje robótico y las ventajas de éste, siendo una técnica segura y eficaz realizada por equipos con experiencia.

Doctors who have participated

Dr. Cugat

Clinical Head of the Hepatobiliopancreatic Surgery Team

Dr. Esteban Cugat (Barcelona, 1960) is a medical specialist in General and Digestive System Surgery. Specialized in Hepatobiliopancreatic Surgery. Clinical Associate Professor at the Faculty of Medicine of the Autonomous University of Barcelona. 

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Dra. Sentí

Consultant in Hepatobiliopancreatic Surgery

Dr. Sara Sentí i Farrarons (Barcelona, 1992) is a Digestive  surgeon developing her clinical practice in hepatobiliopancreatic surgery and pancreatic transplantation.

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Dra. Zárate

Consultant in Hepatobiliopancreatic Surgery

Dr. Alba Zárate (Barcelona, 1989) is a Digestive surgeon specializing in hepatobiliopancreatic surgery and pancreatic transplantation.

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Venous resection in pancreatic oncologic surgery: Different techniques for different situations.

Sara Sentí, Fernando Pardo, Maria Galofré, Francisco Espin, Eric Herrero Fonollosa, Maribel García-Domingo, Manel Cremades, Alba Zárate, Judith Camps, Jordi Navinés y Esteban Cugat.

Retrospective, cross-sectional and comparative analysis. We include 41 patients with malignant pancreatic lesions who underwent surgery with vascular resection due to vascular involvement, from 2013 to 2021.

The aggressive surgical treatment with venous resection in pancreatic malignant lesions to ensure R0 and its vascular reconstruction is a feasible technique, with an acceptable morbid-mortality rate and overall survival.

Doctors who have participated

Dr. Pardo

Consultant in Hepatobiliopancreatic Surgery

Dr. Fernando Pardo (Madrid, 1986) is a Digestive surgeon specializing in hepatobiliopancreatic surgery and pancreatic transplantation.

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Dra. Sentí

Consultant in Hepatobiliopancreatic Surgery

Dr. Sara Sentí i Farrarons (Barcelona, 1992) is a Digestive  surgeon developing her clinical practice in hepatobiliopancreatic surgery and pancreatic transplantation.

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Dr. Espín

Consultant in Hepatobiliopancreatic Surgery

Dr. Francisco Espín is a  Medical specialist in hepatobiliopancreatic (HPB) surgery and pancreatic transplantation. Associate Professor at the Faculty of Medicine at the Autonomous University of Barcelona (Germans Trias Teaching Unit).

View profile

Dra. Zárate

Consultant in Hepatobiliopancreatic Surgery

Dr. Alba Zárate (Barcelona, 1989) is a Digestive surgeon specializing in hepatobiliopancreatic surgery and pancreatic transplantation.

View profile

Dr. Cremades

Consultant in Hepatobiliopancreatic Surgery

Dr. Manel Cremades is a Medical specialist in hepatobiliopancreatic (HPB) surgery and pancreatic transplantation. He is also an Associate Professor at the Faculty of Medicine at the Autonomous University of Barcelona (UAB – Germans Trias Teaching Unit), collaborates on management committees for the implementation of hospital transformation projects, and is the co-founder of two startups in the health sector.

View profile

Dr. Navinés

Consultant in Hepatobiliopancreatic Surgery

Surgeon Specialist in General and Digestive System Surgery and Doctor of Surgery from the Universitat Autònoma de Barcelona.

View profile

Dr. Cugat

Clinical Head of the Hepatobiliopancreatic Surgery Team

Dr. Esteban Cugat (Barcelona, 1960) is a medical specialist in General and Digestive System Surgery. Specialized in Hepatobiliopancreatic Surgery. Clinical Associate Professor at the Faculty of Medicine of the Autonomous University of Barcelona. 

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Long-term results of liver-first approach strategy in patients with advanced synchronous liver metastases from colorectal cancer.

Eric Herrero, María Galofré, Alba Zárate, Maribel García-Domingo, Judith Camps, Fernando Pardo, Francisco Espin y Esteban Cugat.

Retrospective descriptive analysis from a prospective database of hepatectomies from liver metastases (LM) from CRC in two centers. Between 2007-2019, 88 patients with CRC-ASLM (advanced synchronous liver metastases) were included in a LFA scheme. Bilobar (LM) was present in 65.9%, the mean number of lesions was 5.5 and mean size 42.7 mm. Response to treatment was assessed by RECIST criteria. Progression-free survival (PFS) and overall survival (OS) were estimated using Kaplan-Meier survival curves.

In patients with CRC-ASLM the LFA allows control of the liver disease beforehand and an assessment of the tumor response to neoadjuvant chemotherapy, optimising the chance of potentially curative liver resection, which influences long-term survival.

Doctors who have participated

Dra. Zárate

Consultant in Hepatobiliopancreatic Surgery

Dr. Alba Zárate (Barcelona, 1989) is a Digestive surgeon specializing in hepatobiliopancreatic surgery and pancreatic transplantation.

View profile

Dr. Cugat

Clinical Head of the Hepatobiliopancreatic Surgery Team

Dr. Esteban Cugat (Barcelona, 1960) is a medical specialist in General and Digestive System Surgery. Specialized in Hepatobiliopancreatic Surgery. Clinical Associate Professor at the Faculty of Medicine of the Autonomous University of Barcelona. 

View profile

Dr. Pardo

Consultant in Hepatobiliopancreatic Surgery

Dr. Fernando Pardo (Madrid, 1986) is a Digestive surgeon specializing in hepatobiliopancreatic surgery and pancreatic transplantation.

View profile

Dr. Espín

Consultant in Hepatobiliopancreatic Surgery

Dr. Francisco Espín is a  Medical specialist in hepatobiliopancreatic (HPB) surgery and pancreatic transplantation. Associate Professor at the Faculty of Medicine at the Autonomous University of Barcelona (Germans Trias Teaching Unit).

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Luces y sombras de la duodenopancreatectomía cefálica laparoscópica

Francisco Espin, María Isabel García-Domingo, Manel Cremades, Eric Herrero, Jordi Navinés, Judith Camps, Fernando Pardo y Esteban Cugat.

En este estudio se analizan 138 cirugías de duodenopancreatectomía (DPC) realizadas en un periodo de dos años (2017-2019). 23 DPC laparoscópicas, incluyendo patología benigna y maligna. Se valora la eficacia y seguridad y se compara con 31 DPC abiertas en el mismo periodo.

En un grupo seleccionado, la DPC laparoscópica puede realizarse de forma segura y eficaz si se realiza por grupos expertos en cirugía pancreática y en laparoscopia avanzada. Obtiene los mismos resultados que la cirugía abierta en el postoperatorio y es oncológicamente adecuada con menor estancia hospitalaria. Una selección adecuada de los pacientes, un programa establecido por pasos con una conversión laxa y precoz evita accidentes operatorios graves.

Doctors who have participated

Dr. Espín

Consultant in Hepatobiliopancreatic Surgery

Dr. Francisco Espín is a  Medical specialist in hepatobiliopancreatic (HPB) surgery and pancreatic transplantation. Associate Professor at the Faculty of Medicine at the Autonomous University of Barcelona (Germans Trias Teaching Unit).

View profile

Dr. Navinés

Consultant in Hepatobiliopancreatic Surgery

Surgeon Specialist in General and Digestive System Surgery and Doctor of Surgery from the Universitat Autònoma de Barcelona.

View profile

Dr. Cremades

Consultant in Hepatobiliopancreatic Surgery

Dr. Manel Cremades is a Medical specialist in hepatobiliopancreatic (HPB) surgery and pancreatic transplantation. He is also an Associate Professor at the Faculty of Medicine at the Autonomous University of Barcelona (UAB – Germans Trias Teaching Unit), collaborates on management committees for the implementation of hospital transformation projects, and is the co-founder of two startups in the health sector.

View profile

Dr. Cugat

Clinical Head of the Hepatobiliopancreatic Surgery Team

Dr. Esteban Cugat (Barcelona, 1960) is a medical specialist in General and Digestive System Surgery. Specialized in Hepatobiliopancreatic Surgery. Clinical Associate Professor at the Faculty of Medicine of the Autonomous University of Barcelona. 

View profile

Dr. Pardo

Consultant in Hepatobiliopancreatic Surgery

Dr. Fernando Pardo (Madrid, 1986) is a Digestive surgeon specializing in hepatobiliopancreatic surgery and pancreatic transplantation.

View profile