Indocyanine green fluorescent cholangiography in laparoscopic cholecystectomy: A systematic review and meta-analysis with trial sequential analysis of randomized controlled trials
Abstract
BACKGROUND
Indocyanine green fluorescent cholangiography is a noninvasive, real-time visualization method to prevent misinterpretation of biliary anatomy during laparoscopic cholecystectomy. This systematic review and meta-analysis focuses exclusively on randomized controlled trials that assess the efficacy of this technique during laparoscopic cholecystectomy.
METHODS
MEDLINE, Embase, and Cochrane databases were searched up to August 2024. The main endpoints of interest included bile duct injuries and identification success rates of biliary structures. A trial sequential analysis was performed to establish implications for further research.
RESULTS
Eight studies comprising 1,586 patients were included. The results showed no statistically significant differences in bile duct injuries (odds ratio, 0.73; 95% confidence interval, 0.05-10.80; I2 = 32%), identification success rates of the cystic duct (odds ratio, 1.73; 95% confidence interval, 0.78-3.86; I2 = 32%) or common hepatic duct (odds ratio, 2.80; 95% confidence interval, 0.96-8.15; I2 = 82%). However, a significant difference was observed in the success rate odds for identifying the common bile duct (odds ratio, 4.08; 95% confidence interval, 1.77-9.41; I2 = 64%). The trial sequential analysis provided certainty that the improved success rate for identifying the common bile duct is not a result of type 1 error, but further studies are necessary to assess the results of most outcomes.
CONCLUSION
Indocyanine green…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 1,586 participants or records.
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