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Systematic Reviews
Published in: Systematic Reviews 1/2022

Open Access 01-12-2022 | Cholangiography | Protocol

Near infrared indocyanine green fluorescent cholangiography versus intraoperative cholangiography to improve safety in laparoscopic cholecystectomy for gallstone disease—a systematic review protocol

Authors: Mihai-Calin Pavel, Mar Achalandabaso Boira, Yasir Bashir, Robert Memba, Erik Llácer, Laia Estalella, Elisabeth Julià, Kevin C. Conlon, Rosa Jorba

Published in: Systematic Reviews | Issue 1/2022

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Abstract

Background

Laparoscopic cholecystectomy has become the standard surgical approach in the treatment of cholelithiasis. Diverse surgical techniques and different imaging modalities have been described to evaluate the biliary anatomy and prevent or early detect bile duct injuries. X-ray intraoperative cholangiography (IOC) and near infrared indocyanine green fluorescent cholangiography (NIR-ICG) are safe and feasible techniques to assess biliary anatomy. The aim of this systematic review will be to evaluate if NIR-ICG can visualize extrahepatic biliary anatomy more efficiently and safer than IOC in minimally invasive cholecystectomy for gallstone disease.

Methods

Literature search will be performed via MEDLINE (PubMed), Embase, Scopus, the Cochrane Central Register of Controlled Trials, and Web of Science Core Collection from 2009 to present. All randomized controlled clinical trials and prospective non-randomized controlled trials which report on comparison of NIR-ICG versus IOC will be included. All patients over 18 years old who require elective or urgent minimally invasive cholecystectomy (undergoing NIR-ICG during this procedure) due to gallstone disease both acute and chronic will be included. Since BDI has a low incidence, the primary outcome will be the ability to visualize extrahepatic biliary anatomy and the time to obtain relevant images of these structures.
Two researchers will individually screen the identified records, according to a list of inclusion and exclusion criteria. Bias of the studies will be evaluated with the Newcastle-Ottawa score for non-randomized studies and with The Cochrane Risk of Bias Tool for randomized controlled trials. Quality of evidence for all outcomes will be determined with the GRADE system. The data will be registered in a predesigned database. If selected studies are sufficiently homogeneous, we will perform a meta-analysis of reported results. In the event of a substantial heterogeneity, a narrative synthesis will be provided. Subgroup analysis will be used to investigate possible sources of heterogeneity.

Discussion

Understanding the benefits of this technique is critical to ensuring policymakers can make informed decisions as to where preventive efforts should be focused regarding specific imaging techniques. If ICG is proven to be faster and non-invasive, its routine use could be encouraged.

Systematic review registration

PROSPERO CRD42020177991.
Appendix
Available only for authorised users
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Metadata
Title
Near infrared indocyanine green fluorescent cholangiography versus intraoperative cholangiography to improve safety in laparoscopic cholecystectomy for gallstone disease—a systematic review protocol
Authors
Mihai-Calin Pavel
Mar Achalandabaso Boira
Yasir Bashir
Robert Memba
Erik Llácer
Laia Estalella
Elisabeth Julià
Kevin C. Conlon
Rosa Jorba
Publication date
01-12-2022
Publisher
BioMed Central
Published in
Systematic Reviews / Issue 1/2022
Electronic ISSN: 2046-4053
DOI
https://doi.org/10.1186/s13643-022-01907-6

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