Evidence map›Paper›PMID 40634727›Full record

SynthesisSurgical endoscopy2025

Intraoperative imaging of the common bile duct: a systematic review.

Julie Hong, Sunjay Kumar, Intekhab Akram, Sharif Rauf Khan, Lawrence N Cetrulo, Romeo Ignacio, Jeffrey Chiu, Brian Davis, Marian McDonald, Subhashini Ayloo and 6 more

Erratum issuedAbstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Surgical endoscopy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 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

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Guideline
  2. Trial
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

16 authors.

Julie HongDepartment of Surgery, NewYork Presbyterian-Queens, New York, NY, USA.
Sunjay KumarDepartment of Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
Intekhab AkramJawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India.
Sharif Rauf KhanJawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India.
Lawrence N CetruloDepartment of Surgery, University of Washington School of Medicine, Seattle, USA.
Romeo IgnacioDivision of Pediatric Surgery, Department of Surgery, University of California San Diego School of Medicine, San Diego, CA, USA.
Jeffrey ChiuDepartment of Surgery, AdventHealth, Orlando, FL, USA.
Brian DavisChristus Trinity Clinic, Corpus Christi, TX, USA.
Marian McDonaldUniversity of Pennsylvania, Philadelphia, PA, USA.
Subhashini AylooDepartment of Surgery, Aleda E. Lutz VA Medical Center, Sagina, MI, USA.
Ali KchaouDepartment of General and Digestive Surgery, Faculty of Medicine, Habib Bourguiba Hospital, University of Sfax, Sfax, Tunisia.
David OverbyDepartment of Surgery, University of North Carolina, Chapel Hill, NC, USA.
Dena G ShehataDepartment of Surgery, Lahey Hospital and Medical Center, 41 Mall Road, Burlington, MA, USA. dena.g.shehata@gmail.com.ORCID http://orcid.org/0000-0002-6867-4269
Eduardo Moreno-PaquentinDepartment of Surgery, ABC Medical Center, Mexico City, Mexico.
Bethany J SlaterDepartment of Surgery, University of Chicago, Chicago, IL, USA.
Emily MiraflorDepartment of Surgery, University of California-East Bay, Oakland, CA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBenign biliary disease is a common gastrointestinal condition often requiring surgical intervention. Serious complications during minimally invasive cholecystectomy, such as bile duct injury (BDI) and retained common bile duct stones, must be minimized to improve outcomes and optimize resource use. This systematic review summarizes data comparing intraoperative cholangiography (IOC), fluorescent imaging (FI) with indocyanine green (ICG), and laparoscopic ultrasound (LUS) during laparoscopic cholecystectomy.

methodsA systematic review was conducted to address key questions (KQs) on the use of intraoperative common bile duct imaging to prevent BDI and retained stones. Comparisons included routine IOC (KQ1 routine versus selective IOC (KQ1b) in adult and pediatric populations (KQ1p), as well as IOC versus FI with ICG (KQ2) and IOC versus LUS (KQ3). Searches were conducted in PubMed, Embase, Clinicaltrials.gov, ICTRP, and Cochrane databases. Meta-analyses were performed using random effects models (inverse variance and Mantel-Haenszel), and risk of bias was assessed using the Cochrane Risk of Bias tool and a modified Newcastle-Ottawa Scale.

resultsOf 1,981 unique publications, 46 studies met inclusion criteria (KQ1 n = 19, KQ1b n = 7, KQ1p n = 5, KQ2 n = 6, KQ3 n = 9). IOC was associated with increased operative time (Mean difference 22.61 min [95% CI 16.87, 28.34]) and technical failure (OR 8.28 [1.02, 67.47]). Routine IOC showed trends toward reduced bile duct injury (RR 0.66 [0.08, 5.36]) and increased intraoperative stone detection (RR 2.83 [1.08, 7.41]). Compared to FI with ICG, IOC showed a trend toward fewer bile duct injuries (RR 0.33 [0.01, 8.02]) and more frequent stone identification (RR 5.00 [0.25, 102.00]). IOC also reduced the need for second imaging modalities. No differences were found in postoperative stone detection across techniques.

conclusionsRoutine IOC may offer advantages over selective IOC, FI with ICG, and LUS in reducing complications, but is also associated with higher technical failure and longer operative time.

Indexed as

CholangiographyCholecystectomy, LaparoscopicCommon Bile DuctIntraoperative ComplicationsHumansIndocyanine GreenIntraoperative CareOptical ImagingIndocyanine GreenFluorescent imagingGallbladderHepatobiliaryIndocyanine greenIntraoperative cholangiographyLaparoscopic ultrasound

Identifiers

PMID40634727

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.