“…The results were the same when we analysed studies reporting exclusively on LC cases (WMD = 0.04, 95% CI –0.12; 0.19; heterogeneity: I 2 = 90.0%, p < 0.001) (Supplementary Fig. 13) [ 19 , 43 , 56 , 59 ].…”
Section: Resultsmentioning
confidence: 59%
“…1 ). At the end of the selection process, we identified 38 eligible articles [ 14 – 19 , 21 , 31 – 61 ], of which 32 were included in the quantitative synthesis [ 14 – 19 , 21 , 31 – 35 , 37 , 39 – 44 , 46 , 47 , 49 , 50 , 52 – 59 , 61 ]. Fig.…”
Section: Resultsmentioning
confidence: 99%
“…The operation time was significantly longer during cholecystectomy in the IOC group compared to the no IOC group (WMD = 11.25 min, 95% CI 6.57; 15.93; heterogeneity I 2 = 95.9%, p = 0.000) (Supplementary Fig. 10) [ 19 , 33 , 42 , 46 , 49 , 56 , 59 ] .…”
Section: Resultsmentioning
confidence: 99%
“…Comparing IOC and no IOC by length of hospital stay, no statistically significant differences were found (WMD = -0.03, 95% CI –0.26; 0.20; heterogeneity: I 2 = 98.3%, p < 0.001) (Supplementary Fig. 12) [ 14 , 19 , 33 , 43 , 44 , 54 , 56 , 59 ]. The results were the same when we analysed studies reporting exclusively on LC cases (WMD = 0.04, 95% CI –0.12; 0.19; heterogeneity: I 2 = 90.0%, p < 0.001) (Supplementary Fig.…”
Background
Decades of debate surround the use of intraoperative cholangiography (IOC) during cholecystectomy. To the present day, the role of IOC is controversial as regards decreasing the rate of bile duct injury (BDI). We aimed to review and analyse the available literature on the benefits of IOC during cholecystectomy.
Methods
A systematic literature search was performed until 19 October 2020 in five databases using the following search keys: cholangiogra* and cholecystectomy. The primary outcomes were BDI and retained stone rate. To investigate the differences between the groups (routine IOC vs selective IOC and IOC vs no IOC), we calculated weighted mean differences (WMD) for continuous outcomes and relative risks (RR) for dichotomous outcomes, with 95% confidence intervals (CI).
Results
Of the 19,863 articles, 38 were selected and 32 were included in the quantitative synthesis. Routine IOC showed no superiority compared to selective IOC in decreasing BDI (RR = 0.91, 95% CI 0.66; 1.24). Comparing IOC and no IOC, no statistically significant differences were found in the case of BDI, retained stone rate, readmission rate, and length of hospital stay. We found an increased risk of conversion rate to open surgery in the no IOC group (RR = 0.64, CI 0.51; 0.78). The operation time was significantly longer in the IOC group compared to the no IOC group (WMD = 11.25 min, 95% CI 6.57; 15.93).
Conclusion
Our findings suggest that IOC may not be indicated in every case, however, the evidence is very uncertain. Further good quality research is required to address this question.
“…The results were the same when we analysed studies reporting exclusively on LC cases (WMD = 0.04, 95% CI –0.12; 0.19; heterogeneity: I 2 = 90.0%, p < 0.001) (Supplementary Fig. 13) [ 19 , 43 , 56 , 59 ].…”
Section: Resultsmentioning
confidence: 59%
“…1 ). At the end of the selection process, we identified 38 eligible articles [ 14 – 19 , 21 , 31 – 61 ], of which 32 were included in the quantitative synthesis [ 14 – 19 , 21 , 31 – 35 , 37 , 39 – 44 , 46 , 47 , 49 , 50 , 52 – 59 , 61 ]. Fig.…”
Section: Resultsmentioning
confidence: 99%
“…The operation time was significantly longer during cholecystectomy in the IOC group compared to the no IOC group (WMD = 11.25 min, 95% CI 6.57; 15.93; heterogeneity I 2 = 95.9%, p = 0.000) (Supplementary Fig. 10) [ 19 , 33 , 42 , 46 , 49 , 56 , 59 ] .…”
Section: Resultsmentioning
confidence: 99%
“…Comparing IOC and no IOC by length of hospital stay, no statistically significant differences were found (WMD = -0.03, 95% CI –0.26; 0.20; heterogeneity: I 2 = 98.3%, p < 0.001) (Supplementary Fig. 12) [ 14 , 19 , 33 , 43 , 44 , 54 , 56 , 59 ]. The results were the same when we analysed studies reporting exclusively on LC cases (WMD = 0.04, 95% CI –0.12; 0.19; heterogeneity: I 2 = 90.0%, p < 0.001) (Supplementary Fig.…”
Background
Decades of debate surround the use of intraoperative cholangiography (IOC) during cholecystectomy. To the present day, the role of IOC is controversial as regards decreasing the rate of bile duct injury (BDI). We aimed to review and analyse the available literature on the benefits of IOC during cholecystectomy.
Methods
A systematic literature search was performed until 19 October 2020 in five databases using the following search keys: cholangiogra* and cholecystectomy. The primary outcomes were BDI and retained stone rate. To investigate the differences between the groups (routine IOC vs selective IOC and IOC vs no IOC), we calculated weighted mean differences (WMD) for continuous outcomes and relative risks (RR) for dichotomous outcomes, with 95% confidence intervals (CI).
Results
Of the 19,863 articles, 38 were selected and 32 were included in the quantitative synthesis. Routine IOC showed no superiority compared to selective IOC in decreasing BDI (RR = 0.91, 95% CI 0.66; 1.24). Comparing IOC and no IOC, no statistically significant differences were found in the case of BDI, retained stone rate, readmission rate, and length of hospital stay. We found an increased risk of conversion rate to open surgery in the no IOC group (RR = 0.64, CI 0.51; 0.78). The operation time was significantly longer in the IOC group compared to the no IOC group (WMD = 11.25 min, 95% CI 6.57; 15.93).
Conclusion
Our findings suggest that IOC may not be indicated in every case, however, the evidence is very uncertain. Further good quality research is required to address this question.
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