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Comparison of indocyanine green dye fluorescent cholangiography with intra-operative cholangiography in laparoscopic cholecystectomy: a meta-analysis

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Abstract

Objective

To compare indocyanine green dye fluorescence cholangiography (ICG-FC) with intra-operative cholangiography (IOC) in minimal access cholecystectomy for visualization of the extrahepatic biliary tree.

Background

Although studies have shown that ICG-FC is safe, feasible, and comparable to IOC to visualize the extrahepatic biliary tree, there is no comparative review.

Methods

We searched The Embase, PubMed, Cochrane Library, and Web of Science databases up to 8 April 2020 for all studies comparing ICG-FC with IOC in patients undergoing minimal access cholecystectomy. The primary outcomes were percentage visualization of the cystic duct (CD), common bile duct (CBD), CD-CBD junction, and the common hepatic duct (CHD). We used RevMan v5.3 software to analyze the data.

Results

Seven studies including 481 patients were included. Five studies, comprising 275 patients reported higher CD (RR = 0.90, p = 0.12, 95% CI 0.79–1.03, I2 = 74%) and CBD visualization rates (RR = 0.82, p = 0.09, 95% CI 0.65–1.03, I2 = 87%) by ICG-FC. Four studies, comprising 223 patients, reported higher CD-CBD junction visualization rates using ICG-FC compared to IOC (RR = 0.68, p = 0.06, 95% CI = 0.45–1.02, I2 = 94%). Four studies, comprising 210 patients, reported higher CHD visualization rates using ICG-FC compared to IOC (RR = 0.58, p = 0.03, 95% CI 0.35–0.93, I2 = 91%).

Conclusion

ICG-FC is safe, and it improves visualization of CHD.

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Authors and Affiliations

  1. Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

    Sioh Huang Lim & Hui Ting Alyssa Tan

  2. Department of General Surgery, Tan Tock Seng Hospital, Singapore, 308433, Singapore

    Vishal G. Shelat

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  1. Sioh Huang Lim
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Correspondence to Vishal G. Shelat.

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Lim, S.H., Tan, H.T.A. & Shelat, V.G. Comparison of indocyanine green dye fluorescent cholangiography with intra-operative cholangiography in laparoscopic cholecystectomy: a meta-analysis. Surg Endosc 35, 1511–1520 (2021). https://doi.org/10.1007/s00464-020-08164-5

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