Evidence map›Paper›PMID 28457194›Full record

Trial reportSurgical innovation2017

The Best Approach for Laparoscopic Fluorescence Cholangiography: Overview of the Literature and Optimization of Dose and Dosing Time.

Leonora S F Boogerd, Henricus J M Handgraaf, Volkert A L Huurman, Hwai-Ding Lam, J Sven D Mieog, Wendeline J van der Made, Cornelis J H van de Velde, Alexander L Vahrmeijer

Abstract readClinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Surgical innovation, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
44citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

44 citing papers in PubMed, 4 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Leonora S F Boogerd1 Leiden University Medical Center, Leiden, Netherlands.
Henricus J M Handgraaf1 Leiden University Medical Center, Leiden, Netherlands.
Volkert A L Huurman1 Leiden University Medical Center, Leiden, Netherlands.
Hwai-Ding Lam1 Leiden University Medical Center, Leiden, Netherlands.
J Sven D Mieog1 Leiden University Medical Center, Leiden, Netherlands.
Wendeline J van der Made1 Leiden University Medical Center, Leiden, Netherlands.
Cornelis J H van de Velde1 Leiden University Medical Center, Leiden, Netherlands.
Alexander L Vahrmeijer1 Leiden University Medical Center, Leiden, Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFluorescence cholangiography using indocyanine green (ICG) can enhance orientation of bile duct anatomy during laparoscopic cholecystectomy. To ensure clear discrimination between bile ducts and liver, the fluorescence ratio between both should be sufficient. This ratio is influenced by the ICG dose and timing of fluorescence imaging. We first systematically identified all strategies for fluorescence cholangiography. Second, we aimed to optimize the dose of ICG and dosing time in a prospective clinical trial.

methodsPubMed was searched for clinical trials studying fluorescence cholangiography. Furthermore, 28 patients planned to undergo laparoscopic cholecystectomy were divided into 7 groups, receiving different intravenous doses (5 or 10 mg ICG) at different time points (0.5, 2, 4, 6, or 24 hours prior to surgery).

resultsThe systematic review revealed 27 trials including 1057 patients. The majority of studies used 2.5 mg administered within 1 hour before imaging. Imaging 3 to 24 hours after ICG administration was never studied. The clinical trial demonstrated that the highest bile duct-to-liver ratio was achieved 3 to 7 hours after administration of 5 mg and 5 to 25 hours after administration of 10 mg ICG. Up to 3 hours after administration of 5 mg and up to 5 hours after administration of 10 mg ICG, the liver was equally or more fluorescent than the cystic duct, resulting in a ratio ≤1.0.

conclusionThis study shows for the first time that the interval between ICG administration and intraoperative fluorescence cholangiography should be extended. Administering 5 mg ICG at least 3 hours before imaging is easy to implement in everyday clinical practice and results in bile duct-to-liver ratios >1.0.

Indexed as

Fluorescent DyesAdultAgedBile DuctsCholangiographyFemaleHumansIndocyanine GreenLaparoscopyMaleMiddle AgedOptical ImagingProspective StudiesRandomized Controlled Trials as TopicYoung AdultFluorescent DyesIndocyanine Greenbile duct anatomydose and time optimizationfluorescence cholangiographyfluorescence imagingindocyanine greenintraoperative bile duct imaging

Identifiers

PMID28457194
PMCPMC5505227

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.