ReviewSurgery open science2021
A meta-analysis of the use of intraoperative cholangiography; time to revisit our approach to cholecystectomy?
Review in Surgery open science, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 3 of them syntheses that pooled it.
What it found
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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.
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.
Who cites it
19 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Intraoperative imaging of the common bile duct: a systematic review.Surgical endoscopy · 2025Pooled it
- Selective intraoperative cholangiography should be considered over routine intraoperative cholangiography during cholecystectomy: a systematic review and meta-analysis.Surgical endoscopy · 2022Pooled it
- Intraoperative Cholangiography in Laparoscopic Cholecystectomy: A Systematic Review and Meta-Analysis.JSLS : Journal of the Society of Laparoendoscopic SurgeonsPooled it
- Comparative Evaluation of Standard Cholangiography, Intravenous, and Intracholecystic Indocyanine Green Fluorescence Cholangiography During Elective Laparoscopic Cholecystectomy: Results of a Three-Arm Randomized Trial.Medicina (Kaunas, Lithuania) · 2026Trial
- Bile duct injury versus choledocholithiasis: does one outweigh the other in the decision to use intraoperative cholangiogram during laparoscopic cholecystectomy? A model-based economic analysis.Surgical endoscopy · 2026Article
- Bile Duct Injury and Litigation in Laparoscopic Cholecystectomy: A Global Review of Current and Future Preventative Initiatives.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2025Review
- The difficult laparoscopic cholecystectomy: a narrative review.BMC surgery · 2025Review
- Selective vs Routine Cholangiography Across a Health Care Enterprise.JAMA surgery · 2025Article
- 30-day Morbidity and Mortality after Cholecystectomy for Benign Gallbladder Disease (AMBROSE): A Prospective, International Collaborative Cohort Study.Annals of surgery · 2025Observational
- Efficacy of multi-color near-infrared fluorescence with indocyanine green: A new imaging strategy and its early experience in laparoscopic cholecystectomy.World journal of gastrointestinal surgery · 2024Article
- Feasibility of Indocyanine Green Fluorescent Cholangiography Via Inguinal Nodal Injection Approach in Upper Gastrointestinal Oncological Surgeries. A Pilot Study.Indian journal of surgical oncology · 2024Article
- Using neural networks to autonomously assess adequacy in intraoperative cholangiograms.Surgical endoscopy · 2024Article
- Near-infrared cholangiography with intragallbladder indocyanine green injection in minimally invasive cholecystectomy.World journal of gastrointestinal surgery · 2024Review
- The Safety and Cost Analysis of Outpatient Laparoendoscopy in the Treatment of Cholecystocholedocholithiasis: A Retrospective Study.Journal of clinical medicine · 2024Article
- Post-cholecystectomy bile duct injuries: a retrospective cohort study.BMC surgery · 2024Article
- Review
- Epidemiology and outcomes of choledocholithiasis and cholangitis in the United States: trends and urban-rural variations.BMC gastroenterology · 2023Article
- Solve study: a study to capture global variations in practices concerning laparoscopic cholecystectomy.Surgical endoscopy · 2022Article
- [Measures for preventing bile duct injuries during difficult cholecystectomies-Bail-out procedures].Chirurgie (Heidelberg, Germany) · 2022Review
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDespite some evidence of improved survival with intraoperative cholangiography during cholecystectomy, debate has raged about its benefit, in part because of its questionable benefit, time, and resources required to complete.
methodsAn International Prospective Register of Systematic Reviews-registered (ID CRD42018102154) meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines using PubMed, Scopus, Web of Science, and Cochrane library from 2003 to 2018 was undertaken including search strategy "intraoperative AND cholangiogra* AND cholecystectomy." Articles scoring ≥ 16 for comparative and ≥ 10 for noncomparative using the Methodological Index for Non-Randomized Studies criteria were included. A dichotomous random effects meta-analysis using the Mantel-Haenszel method performed on Review Manager Version 5.3 was carried out.
resultsOf 2,059 articles reviewed, 62 met criteria for final analysis. The mean rate of intraoperative cholangiography was 38.8% (range 1.6%-96.4%).There was greater detection of bile duct stones during cholecystectomy with routine intraoperative cholangiography compared with selective intraoperative cholangiography (odds ratio = 3.28, confidence interval = 2.80-3.86, P value < .001). While bile duct injury during cholecystectomy was less with intraoperative cholangiography (0.39%) than without intraoperative cholangiography (0.43%), it was not statistically significant (odds ratio = 0.88, confidence interval = 0.65-1.19, P value = .41). Readmission following cholecystectomy with intraoperative cholangiography was 3.0% compared to 3.5% without intraoperative cholangiography (odds ratio = 0.91, confidence interval = 0.78-1.06, P value = .23).
conclusionThe use of intraoperative cholangiography still has its place in cholecystectomy based on the detection of choledocholithiasis and the potential reduction of unfavorable outcomes associated with common bile duct stones. This meta-analysis, the first to review intraoperative cholangiography use, identified a marked variation in cholangiography use. Retrospective studies limit the ability to critically define association between intraoperative cholangiography use and bile duct injury.
Identifiers
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Registered trials
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