Evidence map›Paper›PMID 40993239›Full record

Trial reportSurgical endoscopy2025

Intracholecystic versus intravenous indocyanine green for visualization of biliary anatomy during laparoscopic cholecystectomy: a randomized controlled study.

Anubhav Vindal, Durlabh J Gogoi, Manu Vats, Pawanindra Lal

Abstract readRandomized Controlled TrialComparative Study
PubMed Publisher
In one paragraph

Trial report in Surgical endoscopy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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

1 citing paper in PubMed.

  1. Article
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

4 authors.

Anubhav VindalDivision of Minimal Access Surgery, Department of Surgery, Maulana Azad Medical College (University of Delhi), New Delhi, 110002, India. avindal.mamc@gmail.com.ORCID http://orcid.org/0000-0002-6986-7572
Durlabh J GogoiDivision of Minimal Access Surgery, Department of Surgery, Maulana Azad Medical College (University of Delhi), New Delhi, 110002, India.
Manu Vats
Pawanindra LalDivision of Minimal Access Surgery, Department of Surgery, Maulana Azad Medical College (University of Delhi), New Delhi, 110002, India.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundUse of Indocyanine green (ICG) dye and near infrared fluorescence has been recently described for visualizing the extrahepatic biliary anatomy during laparoscopic cholecystectomy (LC). The popular route for administration of ICG is intravenous (IV), 30-60 min before surgery. Direct injection of ICG into gall bladder (intracholecystic) (IC) is not commonly used. This study is designed to compare these two routes of ICG for visualization of extrahepatic biliary anatomy. METHODS AND PROCEDURE: Forty patients undergoing elective LC were included and randomized into two groups of 20 patients each: IV-ICG and IC-ICG. In the IV-ICG group, ICG was administered in a dose of 0.01 mg/kg, 30-45 min before induction of anesthesia. In the IC-ICG group, ICG was injected directly into the gall bladder fundus using an 18-gauge needle. The two groups were compared with respect to the time of appearance of fluorescence in the biliary tree. A 5-point score was designed to compare the visualization of the biliary anatomy in the two groups.

resultsThe mean visualization score in the IV-ICG group was 4.25 ± 1.17, while that in the IC-ICG group was 4.1 ± 1.18. The cystic duct could be delineated pre-dissection in 70% patients in IV-ICG and in 85% patients in IC-ICG, which changed to 85% and 95%, respectively, after dissection of Calot's triangle. IV-ICG was found to be better at delineating the common hepatic duct (85%) compared to IC-ICG (45%), while CBD could be seen in 95% and 100% patients, respectively. Two patients in the IC-ICG group had minor leakage of bile from the puncture hole in the fundus.

conclusionsThis study found that the IC-ICG provides a faster visualization of extrahepatic biliary ducts during LC, with a better signal-to-background ratio compared to the IV-ICG. It can be utilized immediately without the need to wait for the dye to be excreted by the liver.

Indexed as

Cholecystectomy, LaparoscopicColoring AgentsGallbladderIndocyanine GreenAdultAgedFemaleHumansInjections, IntravenousMaleMiddle AgedColoring AgentsIndocyanine GreenExtrahepatic biliary ductsIndocyanine greenIntracholecysticLaparoscopic cholecystectomyNear infrared fluorescence

Identifiers

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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.