Randomized clinical trial of routine on-table cholangiography during laparoscopic cholecystectomy

Khan, Omar; Balaji, Sam; Branagan, Graham; Bennett, David; Davies, N.

doi:10.1002/bjs.7356

Cited by 74 publications

(68 citation statements)

References 25 publications

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“…Intraoperative cholangiography also lengthens the operation time (26). On the other hand, performance and interpretation of intra-operative cholangiography should be taught to residents during their general surgery training (27)(28)(29)(30).…”

Section: D) What Is the Role Of Intraoperative Cholangiography In Lapmentioning

confidence: 99%

Prevention and acute management of biliary injuries during laparoscopic cholecystectomy: Expert consensus statement

Abbasoğlu¹,

Tekant²,

Alper³

et al. 2016

UCD

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Gallstone disease is very common and laparoscopic cholecystectomy is one of the most common surgical procedures all over the world. Parallel to the increase in the number of laparoscopic cholecystectomies, bile duct injuries also increased. The reported incidence of bile duct injuries ranges from 0.3% to 1.4%. Many of the bile duct injuries during laparoscopic cholecystectomy are not due to inexperience, but are the result of basic technical failures and misinterpretations. A working group of expert hepatopancreatobiliary surgeons, an endoscopist, and a specialist of forensic medicine study searched and analyzed the publications on safe cholecystectomy and biliary injuries complicating laparoscopic cholecystectomy under the organization of Turkish Hepatopancreatobiliary Surgery Association. After a series of e-mail communications and two conferences, the expert panel developed consensus statements for safe cholecystectomy, management of biliary injuries and medicolegal issues. The panel concluded that iatrogenic biliary injury is an overwhelming complication of laparoscopic cholecystectomy and an important issue in malpractice claims. Misidentification of the biliary system is the major cause of biliary injuries. To avoid this, the "critical view of safety" technique should be employed in all the cases. If biliary injury is identified intraoperatively, reconstruction should only be performed by experienced hepatobiliary surgeons. In the postoperative period, any deviation from the expected clinical course of recovery should alert the surgeon about the possibility of biliary injury.

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Section: D) What Is the Role Of Intraoperative Cholangiography In Lapmentioning

confidence: 99%

Prevention and acute management of biliary injuries during laparoscopic cholecystectomy: Expert consensus statement

Abbasoğlu¹,

Tekant²,

Alper³

et al. 2016

UCD

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“…Several image modalities have been proposed for intraoperative visualization of the bile duct system, including routine use of intraoperative X‐ray cholangiography 8, 9, 10. However, opinions are divided on the effectiveness of intraoperative X‐ray cholangiography to avoid bile duct injury 11, 12, 13, 14.…”

Section: Introductionmentioning

confidence: 99%

Optimal timing of preoperative indocyanine green administration for fluorescent cholangiography during laparoscopic cholecystectomy using the PINPOINT® Endoscopic Fluorescence Imaging System

Tsutsui

Yoshida

Nakagawa

et al. 2017

Asian J Endoscop Surgery

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IntroductionThe PINPOINT® Endoscopic Fluorescence Imaging System (Novadaq, Mississauga, Canada) allows surgeons to visualize the bile ducts during laparoscopic cholecystectomy. Surgeons can continue operation while confirming the bile ducts’ fluorescence with a bright‐field/color image. However, strong fluorescence of the liver can interfere with the surgery. Here, we investigated the optimal timing of indocyanine green administration to allow fluorescent cholangiography to be performed without interference from the liver fluorescence.MethodsA total of 72 patients who underwent laparoscopic cholecystectomy were included in this study. The timing of indocyanine green administration was set immediately before surgery and at 3, 6, 9, 12, 15, 18, and 24 h before surgery. The luminance intensity ratios of gallbladder/liver, cystic duct/liver, and common bile duct/liver were measured using the ImageJ software (National Institutes of Health, Bethesda, USA). Visibility of the gallbladder and bile ducts was classified into three categories (grades A, B, and C) based on the degree of visibility in contrast to the liver.ResultsThe luminance intensity ratio for the gallbladder/liver, cystic duct/liver, and common bile duct/liver was ≥1 in the 15‐, 18‐, and 24‐h groups. The proportion of cases in which evaluators classified the visibility of the gallbladder and bile ducts as grade A (best visibility) reached a peak in the 15‐h group and decreased thereafter.ConclusionsIn the present study, the optimal timing of indocyanine green administration for fluorescent cholangiography during laparoscopic cholecystectomy using the PINPOINT Endoscopic Fluorescence Imaging System was 15 h before surgery.

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“…43−45 However, at one year, the incidence of symptomatic retained stones did not differ significantly be tween the two groups. 44,46 In another trial in which 280 patients were randomly assigned to these two treatment categories, an extended follow-up to eight years postoperatively found no significant difference in the incidence of adverse outcomes between the groups. 9 Similar qualitative observations were made previously in a different context.…”

Section: Do All Stones Require Treatment?mentioning

confidence: 98%

Management of suspected stones in the common bile duct

Almadi

Barkun

2012

CMAJ

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Randomized clinical trial of routine on-table cholangiography during laparoscopic cholecystectomy

Abstract: NCT00806780 (http://www.clinicaltrials.gov).

Cited by 74 publications

References 25 publications

Prevention and acute management of biliary injuries during laparoscopic cholecystectomy: Expert consensus statement

Prevention and acute management of biliary injuries during laparoscopic cholecystectomy: Expert consensus statement

Optimal timing of preoperative indocyanine green administration for fluorescent cholangiography during laparoscopic cholecystectomy using the PINPOINT® Endoscopic Fluorescence Imaging System

Management of suspected stones in the common bile duct

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