{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T09:16:04Z","timestamp":1792574164062,"version":"4.5.0"},"reference-count":20,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T00:00:00Z","timestamp":1764028800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"published-print":{"date-parts":[[2026,5]]},"abstract":"\n Background<\/jats:title>\n Indocyanine green (ICG) fluorescence imaging has emerged as a valuable technique to improve biliary structure visualization and reduce potential risk of laparoscopic cholecystectomy (LC). This meta-analysis was conducted to evaluate the safety and efficacy of ICG fluorescence image-guided LC for difficult gallbladder disease.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Embase, PubMed, Web of Science, and Cochrane library databases were searched to obtain comparative studies. The randomized (RoB2) and non-randomized interventions (ROBINS-I) were used to assess the methodological quality of included studies. The primary outcomes included operative time, blood loss, hospital day, rate of conversion to open, and postoperative complication.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n 9 studies were included in the meta-analysis, including 1 randomized controlled trial, 6 retrospective studies, and 1 prospective study. A total of 1069 patients were included in the study, of whom 526 patients received indocyanine green fluorescent cholangiography (ICG-FC) during difficult laparoscopic cholecystectomy (DLC) and 543 patients received traditional DLC. Compared with the control group, ICG group significantly decreased operative time (SMD -1.08 min; 95% CI-1.99, \u22120.16.\n P<\/jats:italic>\n < 0.05), lower rate of conversion to open (relative risk (RR) 0.25; 95% CI 0.08, 0.78.\n P<\/jats:italic>\n = 0.202), and shorter length of hospital stay (SMD -0.30 d; 95% CI -0.58, \u22120.02.\n P<\/jats:italic>\n < 0.05). The ICG group had similar results compared with the control group in intraoperative blood loss (SMD -1.31\u00a0mL; 95% CI-3.01, 0.38.\n P<\/jats:italic>\n < 0.05) and postoperative complication (RR 0.64; 95% CI 0.38, 1.08.\n P<\/jats:italic>\n = 0.179).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Compared with control group, ICG-FC had better results in operative time, rate of conversion to open, and length of hospital stay for DLC.<\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/00031348251387150","type":"journal-article","created":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T17:25:08Z","timestamp":1764091508000},"page":"1374-1383","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["Evaluating the Safety and Efficacy of Indocyanine Green Fluorescence Imaging for Difficult Laparoscopic Cholecystectomy: A Systematic Review and Meta-Analysis"],"prefix":"10.1177","volume":"92","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3090-7423","authenticated-orcid":false,"given":"Kezhong","family":"Tang","sequence":"first","affiliation":[{"name":"Zhejiang University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yizhao","family":"Zhou","sequence":"additional","affiliation":[{"name":"Zhejiang University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanmo","family":"Liu","sequence":"additional","affiliation":[{"name":"Zhejiang University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoqiang","family":"Xu","sequence":"additional","affiliation":[{"name":"Hangzhou Children\u2019s Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-3563-1128","authenticated-orcid":false,"given":"Li","family":"Liao","sequence":"additional","affiliation":[{"name":"Hangzhou Children\u2019s Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,11,25]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/jmwh.12959"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hbpd.2022.01.002"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000004718"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2023.10.022"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13643-022-01907-6"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2025.109149"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-021-08795-2"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-018-4760-1"},{"issue":"20","key":"e_1_3_3_10_2","first-page":"1518","article-title":"[Value of indocyanine green fluorescence tracer in laparoscopic cholecystectomy for acute cholecystitis]","volume":"102","author":"Zhang XD","year":"2022","unstructured":"Zhang XD, Li T, Jin L, et al. [Value of indocyanine green fluorescence tracer in laparoscopic cholecystectomy for acute cholecystitis]. Zhonghua Yixue Zazhi. 2022;102(20):1518-1522.","journal-title":"Zhonghua Yixue Zazhi"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1089\/lap.2022.0467"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-023-10035-8"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00068-023-02340-7"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/s13304-025-02240-y"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/ases.70092"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-025-11867-2"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000004337"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2008.09.024"},{"key":"e_1_3_3_19_2","first-page":"69","article-title":"Indocyanine green fluorescence in elective and emergency laparoscopic cholecystectomy. A visual snapshot","volume":"37","author":"Tebala GD","year":"2020","unstructured":"Tebala GD, Bond-Smith G. Indocyanine green fluorescence in elective and emergency laparoscopic cholecystectomy. A visual snapshot. Surg Technol Int. 2020;37:69-71.","journal-title":"Surg Technol Int"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLE.0000000000001162"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.asjsur.2023.09.140"}],"container-title":["The American Surgeon\u2122"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348251387150","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00031348251387150","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348251387150","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T03:18:13Z","timestamp":1780543093000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00031348251387150"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,25]]},"references-count":20,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1177\/00031348251387150"],"URL":"https:\/\/doi.org\/10.1177\/00031348251387150","relation":{},"ISSN":["0003-1348","1555-9823"],"issn-type":[{"value":"0003-1348","type":"print"},{"value":"1555-9823","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,25]]}}}