A meta-analysis of the use of intraoperative cholangiography; time to revisit our approach to cholecystectomy?
Journal
Surgery open science
ISSN: 2589-8450
Titre abrégé: Surg Open Sci
Pays: United States
ID NLM: 101768812
Informations de publication
Date de publication:
Jan 2021
Jan 2021
Historique:
received:
03
06
2020
revised:
16
07
2020
accepted:
27
07
2020
entrez:
3
5
2021
pubmed:
4
5
2021
medline:
4
5
2021
Statut:
epublish
Résumé
Despite some evidence of improved survival with intraoperative cholangiography during cholecystectomy, debate has raged about its benefit, in part because of its questionable benefit, time, and resources required to complete. An International Prospective Register of Systematic Reviews-registered (ID CRD42018102154) meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines using PubMed, Scopus, Web of Science, and Cochrane library from 2003 to 2018 was undertaken including search strategy "intraoperative AND cholangiogra* AND cholecystectomy." Articles scoring ≥ 16 for comparative and ≥ 10 for noncomparative using the Methodological Index for Non-Randomized Studies criteria were included. A dichotomous random effects meta-analysis using the Mantel-Haenszel method performed on Review Manager Version 5.3 was carried out. Of 2,059 articles reviewed, 62 met criteria for final analysis. The mean rate of intraoperative cholangiography was 38.8% (range 1.6%-96.4%).There was greater detection of bile duct stones during cholecystectomy with routine intraoperative cholangiography compared with selective intraoperative cholangiography (odds ratio = 3.28, confidence interval = 2.80-3.86, P value < .001). While bile duct injury during cholecystectomy was less with intraoperative cholangiography (0.39%) than without intraoperative cholangiography (0.43%), it was not statistically significant (odds ratio = 0.88, confidence interval = 0.65-1.19, P value = .41). Readmission following cholecystectomy with intraoperative cholangiography was 3.0% compared to 3.5% without intraoperative cholangiography (odds ratio = 0.91, confidence interval = 0.78-1.06, P value = .23). The use of intraoperative cholangiography still has its place in cholecystectomy based on the detection of choledocholithiasis and the potential reduction of unfavorable outcomes associated with common bile duct stones. This meta-analysis, the first to review intraoperative cholangiography use, identified a marked variation in cholangiography use. Retrospective studies limit the ability to critically define association between intraoperative cholangiography use and bile duct injury.
Sections du résumé
BACKGROUND
BACKGROUND
Despite some evidence of improved survival with intraoperative cholangiography during cholecystectomy, debate has raged about its benefit, in part because of its questionable benefit, time, and resources required to complete.
METHODS
METHODS
An International Prospective Register of Systematic Reviews-registered (ID CRD42018102154) meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines using PubMed, Scopus, Web of Science, and Cochrane library from 2003 to 2018 was undertaken including search strategy "intraoperative AND cholangiogra* AND cholecystectomy." Articles scoring ≥ 16 for comparative and ≥ 10 for noncomparative using the Methodological Index for Non-Randomized Studies criteria were included. A dichotomous random effects meta-analysis using the Mantel-Haenszel method performed on Review Manager Version 5.3 was carried out.
RESULTS
RESULTS
Of 2,059 articles reviewed, 62 met criteria for final analysis. The mean rate of intraoperative cholangiography was 38.8% (range 1.6%-96.4%).There was greater detection of bile duct stones during cholecystectomy with routine intraoperative cholangiography compared with selective intraoperative cholangiography (odds ratio = 3.28, confidence interval = 2.80-3.86, P value < .001). While bile duct injury during cholecystectomy was less with intraoperative cholangiography (0.39%) than without intraoperative cholangiography (0.43%), it was not statistically significant (odds ratio = 0.88, confidence interval = 0.65-1.19, P value = .41). Readmission following cholecystectomy with intraoperative cholangiography was 3.0% compared to 3.5% without intraoperative cholangiography (odds ratio = 0.91, confidence interval = 0.78-1.06, P value = .23).
CONCLUSION
CONCLUSIONS
The use of intraoperative cholangiography still has its place in cholecystectomy based on the detection of choledocholithiasis and the potential reduction of unfavorable outcomes associated with common bile duct stones. This meta-analysis, the first to review intraoperative cholangiography use, identified a marked variation in cholangiography use. Retrospective studies limit the ability to critically define association between intraoperative cholangiography use and bile duct injury.
Identifiants
pubmed: 33937738
doi: 10.1016/j.sopen.2020.07.004
pii: S2589-8450(20)30023-3
pmc: PMC8076912
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
8-15Informations de copyright
© 2020 The Authors.
Références
J Am Coll Surg. 2001 Sep;193(3):272-80
pubmed: 11548797
Ann Surg. 2020 Jul;272(1):3-23
pubmed: 32404658
Surg Endosc. 2016 Jun;30(6):2239-43
pubmed: 26335071
Br J Surg. 2011 Mar;98(3):362-7
pubmed: 21254008
Br J Surg. 2020 May;107(6):655-661
pubmed: 32057103
JSLS. 2017 Jul-Sep;21(3):
pubmed: 28951654
Surg Endosc. 1992 May-Jun;6(3):113-4
pubmed: 1502677
ANZ J Surg. 2005 Jun;75(6):378-82
pubmed: 15943720
Surg Endosc. 2006 Apr;20 Suppl 2:S436-40
pubmed: 16557418
ANZ J Surg. 2015 Jan;85(1-2):53-7
pubmed: 23910427
Am Surg. 2004 Mar;70(3):203-6; discussion 206-7
pubmed: 15055842
Ann R Coll Surg Engl. 2010 Apr;92(3):206-10
pubmed: 20223077
Surg Endosc. 2009 Jul;23(7):1470-5
pubmed: 19263129
ANZ J Surg. 2006 May;76(5):335-8
pubmed: 16768693
J Surg Educ. 2013 Mar-Apr;70(2):243-7
pubmed: 23427971
Br J Surg. 2006 Jul;93(7):844-53
pubmed: 16671070
PLoS Med. 2009 Jul 21;6(7):e1000097
pubmed: 19621072
Rev Esp Enferm Dig. 2009 Jan;101(1):20-30
pubmed: 19335030
PLoS One. 2018 Jun 28;13(6):e0199147
pubmed: 29953458
World J Surg. 2005 Nov;29(11):1402-8
pubmed: 16228924
Anaesthesiol Intensive Ther. 2020;52(1):47-55
pubmed: 32090306
ANZ J Surg. 2003 Sep;73(9):712-6
pubmed: 12956787
World J Emerg Surg. 2019 Mar 14;14:12
pubmed: 30911325
Surg Endosc. 2002 Jul;16(7):1098-104
pubmed: 12165830
Chirurgia (Bucur). 2016 Jan-Feb;111(1):26-32
pubmed: 26988536
JAMA Surg. 2014 Oct;149(10):1008-13
pubmed: 25133326
Surg Endosc. 2009 Feb;23(2):384-8
pubmed: 18528611
J Am Coll Surg. 2016 Jul;223(1):110-5
pubmed: 27068843
BMC Surg. 2016 Jul 13;16(1):45
pubmed: 27411676
J Surg Res. 2017 Nov;219:108-115
pubmed: 29078868
Surg Endosc. 2015 Jul;29(7):2033-8
pubmed: 25398193
Surg Endosc. 2014 Mar;28(3):875-85
pubmed: 24162138
Ann Med Surg (Lond). 2018 Nov 05;36:173-177
pubmed: 30505436
J Gastrointest Surg. 2013 Apr;17(4):668-74
pubmed: 23263899
J Am Coll Surg. 2010 Aug;211(2):176-86
pubmed: 20670855
ANZ J Surg. 2018 Sep;88(9):819-820
pubmed: 30182411
Gastroenterol Hepatol Bed Bench. 2013 Spring;6(2):80-5
pubmed: 24834249
BMJ. 2012 May 23;344:e3330
pubmed: 22623634
J Am Coll Surg. 2011 Aug;213(2):267-74
pubmed: 21459631
J Gastrointest Surg. 2013 Mar;17(3):434-42
pubmed: 23292460
Clin Gastroenterol Hepatol. 2009 Sep;7(9):1013-8; quiz 915
pubmed: 19465151
Am J Surg. 2016 Dec;212(6):1047-1053
pubmed: 27780559
Arch Surg. 2006 Dec;141(12):1207-13
pubmed: 17178963
World J Gastroenterol. 2015 Feb 21;21(7):2147-51
pubmed: 25717250
JAMA Surg. 2018 Jul 18;153(7):e181167
pubmed: 29847616
World J Surg. 2005 Aug;29(8):987-93
pubmed: 15977078
World J Surg. 2020 Mar;44(3):721-729
pubmed: 31654201
Br J Surg. 2012 Feb;99(2):160-7
pubmed: 22183717
Am J Surg. 2019 May;217(5):970-973
pubmed: 30935666
Surg Endosc. 2016 May;30(5):1804-11
pubmed: 26194264
Surgery. 2011 Oct;150(4):810-9
pubmed: 22000195
Surg Endosc. 2016 Dec;30(12):5395-5403
pubmed: 27105616
J Gastrointest Surg. 2010 Aug;14(8):1280-4
pubmed: 20535578
J Am Coll Surg. 2012 Apr;214(4):668-79; discussion 679-81
pubmed: 22366491
Ann R Coll Surg Engl. 2016 Apr;98(4):244-9
pubmed: 26985813
Int J Clin Pract. 2008 Nov;62(11):1715-9
pubmed: 17887996
BMJ. 2012 Oct 11;345:e6457
pubmed: 23060654
Int Surg. 2006 Mar-Apr;91(2):90-3
pubmed: 16774179
Surgeon. 2019 Dec;17(6):351-359
pubmed: 30704859
JAMA. 2013 Aug 28;310(8):812-20
pubmed: 23982367
Surg Endosc. 2009 Feb;23(2):304-12
pubmed: 18398646
Ann Surg. 2018 Aug;268(2):247-253
pubmed: 29533266
Br J Surg. 2014 May;101(6):677-84
pubmed: 24664658
HPB (Oxford). 2014 Jul;16(7):629-34
pubmed: 24246139
Ann Surg. 2004 Jan;239(1):28-33
pubmed: 14685097
Gastrointest Endosc. 2000 Feb;51(2):175-9
pubmed: 10650260
Br J Surg. 2011 Mar;98(3):391-6
pubmed: 21254014
Ann R Coll Surg Engl. 2019 Jul;101(6):428-431
pubmed: 31155897
J Gastrointest Surg. 2007 Sep;11(9):1162-7
pubmed: 17602271
JAMA. 2003 Apr 2;289(13):1639-44
pubmed: 12672731
Surgeon. 2005 Oct;3(5):352-6
pubmed: 16245655
Am Surg. 2005 Jul;71(7):606-12
pubmed: 16089128
Surgeon. 2019 Feb;17(1):33-42
pubmed: 29730174
BJS Open. 2020 Aug;4(4):622-629
pubmed: 32418332
Surg Endosc. 2006 Jun;20(6):868-74
pubmed: 16738972
Am J Surg. 2013 Apr;205(4):371-3
pubmed: 23518180
J Gastroenterol. 2020 Jan;55(1):78-85
pubmed: 31473828
Surg Endosc. 2018 Feb;32(2):667-674
pubmed: 28726135
Surg Endosc. 2005 Apr;19(4):589-93
pubmed: 15759189
ANZ J Surg. 2019 Jul;89(7-8):889-894
pubmed: 31083792
Am J Surg. 2017 Oct;214(4):682-686
pubmed: 28669532
Clin Res Hepatol Gastroenterol. 2015 Oct;39(5):584-93
pubmed: 25936687
Surg Endosc. 2012 Apr;26(4):1122-7
pubmed: 22170316
Surg Endosc. 2011 Dec;25(12):3747-51
pubmed: 21656070
Arch Surg. 2011 Mar;146(3):329-33
pubmed: 21422365
J Visc Surg. 2010 Aug;147(4):e253-7
pubmed: 20920905
Br J Surg. 2015 Jul;102(8):952-8
pubmed: 25919401
Eur J Trauma Emerg Surg. 2019 Apr;45(2):337-342
pubmed: 29417182
Mil Med. 2015 May;180(5):565-9
pubmed: 25939112