Kumar Sunjay K, Shehata Dena G, Cetrulo Lawrence N, Ignacio Romeo, Chiu Jeffrey, Davis Brain R, McDonald Marian, Bloom Matthew B, Ayloo Subhashini, Kchaou Ali, Orthopoulos Georgios, Pucher Philip H, Oliphant Uretz, Hallowell Peter T, Serrot Federico, Overby David, Moreno-Paquentin Eduardo, Slater Bethany J, Miraflor Emily
Department of Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
Department of Surgery, Lahey Hospital and Medical Center, Burlington, MA, USA.
Surg Endosc. 2025 Sep 11. doi: 10.1007/s00464-025-12142-0.
There are multiple intraoperative imaging techniques used to increase safety during laparoscopic cholecystectomy, including intraoperative cholangiography (IOC), fluorescence imaging (FI) with indocyanine green (ICG), and laparoscopic ultrasound (LUS). This guideline addresses the optimal intraoperative imaging technique during laparoscopic cholecystectomy for benign biliary disease.
A systematic review was conducted to address five key questions regarding the use of intraoperative imaging of the common bile duct. These results were then presented to a panel of practicing surgeons who formulated recommendations based on the best available evidence.
Conditional recommendations were made in favor of performing IOC in adult and pediatric patients and doing so routinely rather than selectively, IOC rather than FI with ICG, and either IOC or LUS.
These recommendations should provide guidance regarding the use of intraoperative imaging techniques during laparoscopic cholecystectomy. This guideline also identifies important areas where the future research should focus to strengthen the evidence base.
有多种术中成像技术可用于提高腹腔镜胆囊切除术的安全性，包括术中胆管造影（IOC）、使用吲哚菁绿（ICG）的荧光成像（FI）以及腹腔镜超声（LUS）。本指南阐述了腹腔镜胆囊切除术中治疗良性胆道疾病时的最佳术中成像技术。
进行了一项系统评价，以解决关于胆总管术中成像使用的五个关键问题。然后将这些结果提交给一组执业外科医生，他们根据现有最佳证据制定了建议。
提出了有条件的建议，支持在成人和儿童患者中常规而非选择性地进行IOC，优先选择IOC而非使用ICG的FI，以及IOC或LUS二者任选其一。
这些建议应为腹腔镜胆囊切除术中术中成像技术的使用提供指导。本指南还确定了未来研究应重点关注以加强证据基础的重要领域。
