<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT03817723</url>
  </required_header>
  <id_info>
    <org_study_id>Rad1</org_study_id>
    <nct_id>NCT03817723</nct_id>
  </id_info>
  <brief_title>Radiation Exposure in Intraoperative Cholangiography</brief_title>
  <official_title>Radiation Exposure of Intraoperative Cholangiography During Cholecystectomy</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>Jyväskylä Central Hospital</agency>
      <agency_class>Other</agency_class>
    </lead_sponsor>
  </sponsors>
  <source>Jyväskylä Central Hospital</source>
  <oversight_info>
    <has_dmc>No</has_dmc>
    <is_fda_regulated_drug>No</is_fda_regulated_drug>
    <is_fda_regulated_device>No</is_fda_regulated_device>
  </oversight_info>
  <brief_summary>
    <textblock>
      Aims: to determine the radiation exposure of routine intraoperative cholangiography (IOC&#xD;
      )during cholecystectomy and examine the factors affecting radiation dose and fluoroscopy time&#xD;
      (FT).&#xD;
&#xD;
      Methods: 598 intraoperative cholangiography examinations were performed at the Central&#xD;
      Finland Central Hospital. In this study we included 324 intraoperative cholangiographies&#xD;
      performed with c-arm equipment not exceeding 10 years of age.&#xD;
    </textblock>
  </brief_summary>
  <detailed_description>
    <textblock>
      From January 2016 to December 2017, consecutive 598 intraoperative cholangiography&#xD;
      examinations were performed at the Central Finland Central Hospital. In this study we&#xD;
      included 353 cholangiographies, that were performed with our c-arm equipment not exceeding 10&#xD;
      years of age in the beginning of 2016. The main measures of outcome were the recorded&#xD;
      radiation dose data of c-arm systems from our manual database .&#xD;
&#xD;
      Another 25 cases were excluded because it was not possible to cross-check the manually&#xD;
      recorded radiation dose data from the Picture Archiving and Communication System (PACS ).&#xD;
      Additional 4 patients who underwent intraoperative endoscopic retrograde&#xD;
      cholangiopancreatography (ERCP) were removed from the radiation exposure analysis because IOC&#xD;
      and ERCP were performed consequently with the same c-arm and the radiation exposure of IOC&#xD;
      could not be separated from the registered total KAP and FT. Thus the final analysis&#xD;
      consisted of 324 IOCs. KAP (Kerma area product) is the product of air Kerma in the center of&#xD;
      the imaging area multiplied with size of the imaging area. For simplicity we have unified&#xD;
      varying units received from different c-arms and will only use Gray multiplied by square&#xD;
      centimeters (Gycm2 ). KAP values were measured using inbuilt ionization chambers in c-arms.&#xD;
      For this study we collected the KAP values from exposure and pulsed fluoroscopy. We also&#xD;
      recorded the fluoroscopy time (s).&#xD;
&#xD;
      Laparoscopic cholecystectomies were performed both by residents and specialist surgeons.&#xD;
&#xD;
      Ethics: No ethical approval or written informed consent were needed because the study was&#xD;
      retrospective in nature. The study was approved by the hospital administration.&#xD;
    </textblock>
  </detailed_description>
  <overall_status>Completed</overall_status>
  <start_date type="Actual">January 1, 2016</start_date>
  <completion_date type="Actual">September 1, 2018</completion_date>
  <primary_completion_date type="Actual">December 31, 2017</primary_completion_date>
  <study_type>Observational</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <observational_model>Cohort</observational_model>
    <time_perspective>Retrospective</time_perspective>
  </study_design_info>
  <primary_outcome>
    <measure>mean kerma area product (KAP)</measure>
    <time_frame>2 years</time_frame>
    <description>KAP values were measured using inbuilt ionization chambers in c-arms.</description>
  </primary_outcome>
  <secondary_outcome>
    <measure>mean fluoroscopy time (FT )</measure>
    <time_frame>2 years</time_frame>
    <description>recorded from c -arms</description>
  </secondary_outcome>
  <number_of_groups>2</number_of_groups>
  <enrollment type="Actual">324</enrollment>
  <condition>Radiation Exposure</condition>
  <arm_group>
    <arm_group_label>Specialist surgeon</arm_group_label>
    <description>Radiation exposure of intraoperative cholangiography during cholecystectomy. C-arm cholangiography is performed routinely. KAP (Kerma area product) is the product of air Kerma in the center of the imaging area multiplied with size of the imaging area. For simplicity we have unified varying units received from different c-arms and will only use Gray multiplied by square centimeters (Gycm2 ). KAP values were measured using inbuilt ionization chambers in c-arms. For this study we collected the KAP values from exposure and pulsed fluoroscopy. We also recorded the fluoroscopy time (s).</description>
  </arm_group>
  <arm_group>
    <arm_group_label>Resident surgeon</arm_group_label>
    <description>Radiation exposure of intraoperative cholangiography during cholecystectomy.C-arm cholangiography is performed routinely. KAP (Kerma area product) is the product of air Kerma in the center of the imaging area multiplied with size of the imaging area. For simplicity we have unified varying units received from different c-arms and will only use Gray multiplied by square centimeters (Gycm2 ). KAP values were measured using inbuilt ionization chambers in c-arms. For this study we collected the KAP values from exposure and pulsed fluoroscopy. We also recorded the fluoroscopy time (s).</description>
  </arm_group>
  <intervention>
    <intervention_type>Radiation</intervention_type>
    <intervention_name>c-arm cholangiography</intervention_name>
    <arm_group_label>Resident surgeon</arm_group_label>
    <arm_group_label>Specialist surgeon</arm_group_label>
  </intervention>
  <eligibility>
    <study_pop>
      <textblock>
        Patients who underwent laparoscopic , open or conversion cholecystectomy with&#xD;
        intraoperative cholangiography&#xD;
      </textblock>
    </study_pop>
    <sampling_method>Non-Probability Sample</sampling_method>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
          -  Consecutive intraoperative cholangiographies performed with c-arm equipment not&#xD;
             exceeding 10 years of age between January 2016 to December 2017&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
          -  intraoperative cholangiographies performed with c-arm equipment exceeding over 10&#xD;
             years of age between January 2016 to December 2017&#xD;
&#xD;
          -  patients who underwent intraoperative endoscopic retrograde cholangiopancreatography&#xD;
             (ERCP)&#xD;
&#xD;
          -  if the manually recorded radiation dose data could not be cross-checked from the&#xD;
             Picture Archiving and Communication System ( PACS ) system&#xD;
      </textblock>
    </criteria>
    <gender>All</gender>
    <minimum_age>N/A</minimum_age>
    <maximum_age>N/A</maximum_age>
    <healthy_volunteers>No</healthy_volunteers>
  </eligibility>
  <overall_official>
    <last_name>Anne Mattila, M.D., Ph.D.</last_name>
    <role>Principal Investigator</role>
    <affiliation>consultant surgeon</affiliation>
  </overall_official>
  <location>
    <facility>
      <name>Central Finland Central Hospital</name>
      <address>
        <city>Jyväskylä</city>
        <zip>40620</zip>
        <country>Finland</country>
      </address>
    </facility>
  </location>
  <location_countries>
    <country>Finland</country>
  </location_countries>
  <reference>
    <citation>Ford JA, Soop M, Du J, Loveday BP, Rodgers M. Systematic review of intraoperative cholangiography in cholecystectomy. Br J Surg. 2012 Feb;99(2):160-7. doi: 10.1002/bjs.7809. Epub 2011 Dec 19.</citation>
    <PMID>22183717</PMID>
  </reference>
  <reference>
    <citation>Murison MS, Gartell PC, McGinn FP. Does selective peroperative cholangiography result in missed common bile duct stones? J R Coll Surg Edinb. 1993 Aug;38(4):220-4.</citation>
    <PMID>7693932</PMID>
  </reference>
  <reference>
    <citation>Tusek D, Hufschmidt M, Raguse T. [Value of intraoperative laparoscopic cholangiography]. Zentralbl Chir. 1997;122(3):153-6. German.</citation>
    <PMID>9206908</PMID>
  </reference>
  <reference>
    <citation>Hauer-Jensen M, Karesen R, Nygaard K, Solheim K, Amlie EJ, Havig O, Rosseland AR. Prospective randomized study of routine intraoperative cholangiography during open cholecystectomy: long-term follow-up and multivariate analysis of predictors of choledocholithiasis. Surgery. 1993 Mar;113(3):318-23.</citation>
    <PMID>8441966</PMID>
  </reference>
  <reference>
    <citation>Nies C, Bauknecht F, Groth C, Clerici T, Bartsch D, Lange J, Rothmund M. [Intraoperative cholangiography as a routine method? A prospective, controlled, randomized study]. Chirurg. 1997 Sep;68(9):892-7. doi: 10.1007/s001040050290. German.</citation>
    <PMID>9410677</PMID>
  </reference>
  <reference>
    <citation>Amott D, Webb A, Tulloh B. Prospective comparison of routine and selective operative cholangiography. ANZ J Surg. 2005 Jun;75(6):378-82. doi: 10.1111/j.1445-2197.2005.03393.x.</citation>
    <PMID>15943720</PMID>
  </reference>
  <reference>
    <citation>Khan OA, Balaji S, Branagan G, Bennett DH, Davies N. Randomized clinical trial of routine on-table cholangiography during laparoscopic cholecystectomy. Br J Surg. 2011 Mar;98(3):362-7. doi: 10.1002/bjs.7356. Epub 2010 Nov 24.</citation>
    <PMID>21254008</PMID>
  </reference>
  <reference>
    <citation>Rehani MM, Ciraj-Bjelac O, Vano E, Miller DL, Walsh S, Giordano BD, Persliden J. ICRP Publication 117. Radiological protection in fluoroscopically guided procedures performed outside the imaging department. Ann ICRP. 2010 Dec;40(6):1-102. doi: 10.1016/j.icrp.2012.03.001. Erratum In: Ann ICRP. 2016 Dec;45(3-4):351.</citation>
    <PMID>22732420</PMID>
  </reference>
  <reference>
    <citation>Greffier J, Etard C, Mares O, Pereira F, Defez D, Duverger C, Branchereau P, Beregi JP, Coulomb R, Larbi A. Patient dose reference levels in surgery: a multicenter study. Eur Radiol. 2019 Feb;29(2):674-681. doi: 10.1007/s00330-018-5600-2. Epub 2018 Aug 1. Erratum In: Eur Radiol. 2018 Aug 30;:</citation>
    <PMID>30069810</PMID>
  </reference>
  <reference>
    <citation>Karthikesalingam A, Markar SR, Weerakkody R, Walsh SR, Carroll N, Praseedom RK. Radiation exposure during laparoscopic cholecystectomy with routine intraoperative cholangiography. Surg Endosc. 2009 Aug;23(8):1845-8. doi: 10.1007/s00464-008-0279-0. Epub 2009 Jan 1.</citation>
    <PMID>19118424</PMID>
  </reference>
  <reference>
    <citation>Overby DW, Apelgren KN, Richardson W, Fanelli R; Society of American Gastrointestinal and Endoscopic Surgeons. SAGES guidelines for the clinical application of laparoscopic biliary tract surgery. Surg Endosc. 2010 Oct;24(10):2368-86. doi: 10.1007/s00464-010-1268-7. Epub 2010 Aug 13. No abstract available.</citation>
    <PMID>20706739</PMID>
  </reference>
  <reference>
    <citation>Singh AN, Kilambi R. Single-stage laparoscopic common bile duct exploration and cholecystectomy versus two-stage endoscopic stone extraction followed by laparoscopic cholecystectomy for patients with gallbladder stones with common bile duct stones: systematic review and meta-analysis of randomized trials with trial sequential analysis. Surg Endosc. 2018 Sep;32(9):3763-3776. doi: 10.1007/s00464-018-6170-8. Epub 2018 Mar 30.</citation>
    <PMID>29603004</PMID>
  </reference>
  <reference>
    <citation>Moller M, Gustafsson U, Rasmussen F, Persson G, Thorell A. Natural course vs interventions to clear common bile duct stones: data from the Swedish Registry for Gallstone Surgery and Endoscopic Retrograde Cholangiopancreatography (GallRiks). JAMA Surg. 2014 Oct;149(10):1008-13. doi: 10.1001/jamasurg.2014.249.</citation>
    <PMID>25133326</PMID>
  </reference>
  <reference>
    <citation>Videhult P, Sandblom G, Rasmussen IC. How reliable is intraoperative cholangiography as a method for detecting common bile duct stones? : A prospective population-based study on 1171 patients. Surg Endosc. 2009 Feb;23(2):304-12. doi: 10.1007/s00464-008-9883-2. Epub 2008 Apr 9.</citation>
    <PMID>18398646</PMID>
  </reference>
  <reference>
    <citation>Vlek SL, van Dam DA, Rubinstein SM, de Lange-de Klerk ESM, Schoonmade LJ, Tuynman JB, Meijerink WJHJ, Ankersmit M. Biliary tract visualization using near-infrared imaging with indocyanine green during laparoscopic cholecystectomy: results of a systematic review. Surg Endosc. 2017 Jul;31(7):2731-2742. doi: 10.1007/s00464-016-5318-7. Epub 2016 Nov 14.</citation>
    <PMID>27844236</PMID>
  </reference>
  <reference>
    <citation>Jolley J, Lomelin D, Simorov A, Tadaki C, Oleynikov D. Resident involvement in laparoscopic procedures does not worsen clinical outcomes but may increase operative times and length of hospital stay. Surg Endosc. 2016 Sep;30(9):3783-91. doi: 10.1007/s00464-015-4674-z. Epub 2015 Nov 19.</citation>
    <PMID>26585194</PMID>
  </reference>
  <results_reference>
    <citation>Buddingh KT, Weersma RK, Savenije RA, van Dam GM, Nieuwenhuijs VB. Lower rate of major bile duct injury and increased intraoperative management of common bile duct stones after implementation of routine intraoperative cholangiography. J Am Coll Surg. 2011 Aug;213(2):267-74. doi: 10.1016/j.jamcollsurg.2011.03.004. Epub 2011 Apr 3.</citation>
    <PMID>21459631</PMID>
  </results_reference>
  <verification_date>January 2019</verification_date>
  <study_first_submitted>January 23, 2019</study_first_submitted>
  <study_first_submitted_qc>January 23, 2019</study_first_submitted_qc>
  <study_first_posted type="Actual">January 25, 2019</study_first_posted>
  <last_update_submitted>January 23, 2019</last_update_submitted>
  <last_update_submitted_qc>January 23, 2019</last_update_submitted_qc>
  <last_update_posted type="Actual">January 25, 2019</last_update_posted>
  <responsible_party>
    <responsible_party_type>Principal Investigator</responsible_party_type>
    <investigator_affiliation>Jyväskylä Central Hospital</investigator_affiliation>
    <investigator_full_name>Olli Helminen</investigator_full_name>
    <investigator_title>M.D, Ph.D.</investigator_title>
  </responsible_party>
  <keyword>Radiation dose</keyword>
  <keyword>cholangiography</keyword>
  <keyword>Cholecystectomy</keyword>
  <patient_data>
    <sharing_ipd>No</sharing_ipd>
  </patient_data>
  <provided_document_section>
    <provided_document>
      <document_type>Statistical Analysis Plan</document_type>
      <document_has_protocol>No</document_has_protocol>
      <document_has_icf>No</document_has_icf>
      <document_has_sap>Yes</document_has_sap>
      <document_date>October 1, 2018</document_date>
      <document_url>https://ClinicalTrials.gov/ProvidedDocs/23/NCT03817723/SAP_000.pdf</document_url>
    </provided_document>
  </provided_document_section>
  <!-- Results have not yet been posted for this study                                          -->
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT03817723
org study id: Rad1
nct id: NCT03817723
lead sponsor: 
has dmc: No
is fda regulated drug: No
is fda regulated device: No
Aims: to determine the radiation exposure of routine intraoperative cholangiography (IOC
      )during cholecystectomy and examine the factors affecting radiation dose and fluoroscopy time
      (FT).

      Methods: 598 intraoperative cholangiography examinations were performed at the Central
      Finland Central Hospital. In this study we included 324 intraoperative cholangiographies
      performed with c-arm equipment not exceeding 10 years of age.
From January 2016 to December 2017, consecutive 598 intraoperative cholangiography
      examinations were performed at the Central Finland Central Hospital. In this study we
      included 353 cholangiographies, that were performed with our c-arm equipment not exceeding 10
      years of age in the beginning of 2016. The main measures of outcome were the recorded
      radiation dose data of c-arm systems from our manual database .

      Another 25 cases were excluded because it was not possible to cross-check the manually
      recorded radiation dose data from the Picture Archiving and Communication System (PACS ).
      Additional 4 patients who underwent intraoperative endoscopic retrograde
      cholangiopancreatography (ERCP) were removed from the radiation exposure analysis because IOC
      and ERCP were performed consequently with the same c-arm and the radiation exposure of IOC
      could not be separated from the registered total KAP and FT. Thus the final analysis
      consisted of 324 IOCs. KAP (Kerma area product) is the product of air Kerma in the center of
      the imaging area multiplied with size of the imaging area. For simplicity we have unified
      varying units received from different c-arms and will only use Gray multiplied by square
      centimeters (Gycm2 ). KAP values were measured using inbuilt ionization chambers in c-arms.
      For this study we collected the KAP values from exposure and pulsed fluoroscopy. We also
      recorded the fluoroscopy time (s).

      Laparoscopic cholecystectomies were performed both by residents and specialist surgeons.

      Ethics: No ethical approval or written informed consent were needed because the study was
      retrospective in nature. The study was approved by the hospital administration.
observational model: Cohort
time perspective: Retrospective
measure: mean kerma area product (KAP)
time frame: 2 years
description: KAP values were measured using inbuilt ionization chambers in c-arms.
measure: mean fluoroscopy time (FT )
time frame: 2 years
description: recorded from c -arms
arm group label: Specialist surgeon
description: Radiation exposure of intraoperative cholangiography during cholecystectomy. C-arm cholangiography is performed routinely. KAP (Kerma area product) is the product of air Kerma in the center of the imaging area multiplied with size of the imaging area. For simplicity we have unified varying units received from different c-arms and will only use Gray multiplied by square centimeters (Gycm2 ). KAP values were measured using inbuilt ionization chambers in c-arms. For this study we collected the KAP values from exposure and pulsed fluoroscopy. We also recorded the fluoroscopy time (s).
arm group label: Resident surgeon
description: Radiation exposure of intraoperative cholangiography during cholecystectomy.C-arm cholangiography is performed routinely. KAP (Kerma area product) is the product of air Kerma in the center of the imaging area multiplied with size of the imaging area. For simplicity we have unified varying units received from different c-arms and will only use Gray multiplied by square centimeters (Gycm2 ). KAP values were measured using inbuilt ionization chambers in c-arms. For this study we collected the KAP values from exposure and pulsed fluoroscopy. We also recorded the fluoroscopy time (s).
intervention type: Radiation
intervention name: c-arm cholangiography
arm group label: Resident surgeon
arm group label: Specialist surgeon
study pop: 
sampling method: Non-Probability Sample
criteria: 
gender: All
minimum age: N/A
maximum age: N/A
healthy volunteers: No
last name: Anne Mattila, M.D., Ph.D.
role: Principal Investigator
affiliation: consultant surgeon
facility: 
country: Finland
citation: Ford JA, Soop M, Du J, Loveday BP, Rodgers M. Systematic review of intraoperative cholangiography in cholecystectomy. Br J Surg. 2012 Feb;99(2):160-7. doi: 10.1002/bjs.7809. Epub 2011 Dec 19.
PMID: 22183717
citation: Murison MS, Gartell PC, McGinn FP. Does selective peroperative cholangiography result in missed common bile duct stones? J R Coll Surg Edinb. 1993 Aug;38(4):220-4.
PMID: 7693932
citation: Tusek D, Hufschmidt M, Raguse T. [Value of intraoperative laparoscopic cholangiography]. Zentralbl Chir. 1997;122(3):153-6. German.
PMID: 9206908
citation: Hauer-Jensen M, Karesen R, Nygaard K, Solheim K, Amlie EJ, Havig O, Rosseland AR. Prospective randomized study of routine intraoperative cholangiography during open cholecystectomy: long-term follow-up and multivariate analysis of predictors of choledocholithiasis. Surgery. 1993 Mar;113(3):318-23.
PMID: 8441966
citation: Nies C, Bauknecht F, Groth C, Clerici T, Bartsch D, Lange J, Rothmund M. [Intraoperative cholangiography as a routine method? A prospective, controlled, randomized study]. Chirurg. 1997 Sep;68(9):892-7. doi: 10.1007/s001040050290. German.
PMID: 9410677
citation: Amott D, Webb A, Tulloh B. Prospective comparison of routine and selective operative cholangiography. ANZ J Surg. 2005 Jun;75(6):378-82. doi: 10.1111/j.1445-2197.2005.03393.x.
PMID: 15943720
citation: Khan OA, Balaji S, Branagan G, Bennett DH, Davies N. Randomized clinical trial of routine on-table cholangiography during laparoscopic cholecystectomy. Br J Surg. 2011 Mar;98(3):362-7. doi: 10.1002/bjs.7356. Epub 2010 Nov 24.
PMID: 21254008
citation: Rehani MM, Ciraj-Bjelac O, Vano E, Miller DL, Walsh S, Giordano BD, Persliden J. ICRP Publication 117. Radiological protection in fluoroscopically guided procedures performed outside the imaging department. Ann ICRP. 2010 Dec;40(6):1-102. doi: 10.1016/j.icrp.2012.03.001. Erratum In: Ann ICRP. 2016 Dec;45(3-4):351.
PMID: 22732420
citation: Greffier J, Etard C, Mares O, Pereira F, Defez D, Duverger C, Branchereau P, Beregi JP, Coulomb R, Larbi A. Patient dose reference levels in surgery: a multicenter study. Eur Radiol. 2019 Feb;29(2):674-681. doi: 10.1007/s00330-018-5600-2. Epub 2018 Aug 1. Erratum In: Eur Radiol. 2018 Aug 30;:
PMID: 30069810
citation: Karthikesalingam A, Markar SR, Weerakkody R, Walsh SR, Carroll N, Praseedom RK. Radiation exposure during laparoscopic cholecystectomy with routine intraoperative cholangiography. Surg Endosc. 2009 Aug;23(8):1845-8. doi: 10.1007/s00464-008-0279-0. Epub 2009 Jan 1.
PMID: 19118424
citation: Overby DW, Apelgren KN, Richardson W, Fanelli R; Society of American Gastrointestinal and Endoscopic Surgeons. SAGES guidelines for the clinical application of laparoscopic biliary tract surgery. Surg Endosc. 2010 Oct;24(10):2368-86. doi: 10.1007/s00464-010-1268-7. Epub 2010 Aug 13. No abstract available.
PMID: 20706739
citation: Singh AN, Kilambi R. Single-stage laparoscopic common bile duct exploration and cholecystectomy versus two-stage endoscopic stone extraction followed by laparoscopic cholecystectomy for patients with gallbladder stones with common bile duct stones: systematic review and meta-analysis of randomized trials with trial sequential analysis. Surg Endosc. 2018 Sep;32(9):3763-3776. doi: 10.1007/s00464-018-6170-8. Epub 2018 Mar 30.
PMID: 29603004
citation: Moller M, Gustafsson U, Rasmussen F, Persson G, Thorell A. Natural course vs interventions to clear common bile duct stones: data from the Swedish Registry for Gallstone Surgery and Endoscopic Retrograde Cholangiopancreatography (GallRiks). JAMA Surg. 2014 Oct;149(10):1008-13. doi: 10.1001/jamasurg.2014.249.
PMID: 25133326
citation: Videhult P, Sandblom G, Rasmussen IC. How reliable is intraoperative cholangiography as a method for detecting common bile duct stones? : A prospective population-based study on 1171 patients. Surg Endosc. 2009 Feb;23(2):304-12. doi: 10.1007/s00464-008-9883-2. Epub 2008 Apr 9.
PMID: 18398646
citation: Vlek SL, van Dam DA, Rubinstein SM, de Lange-de Klerk ESM, Schoonmade LJ, Tuynman JB, Meijerink WJHJ, Ankersmit M. Biliary tract visualization using near-infrared imaging with indocyanine green during laparoscopic cholecystectomy: results of a systematic review. Surg Endosc. 2017 Jul;31(7):2731-2742. doi: 10.1007/s00464-016-5318-7. Epub 2016 Nov 14.
PMID: 27844236
citation: Jolley J, Lomelin D, Simorov A, Tadaki C, Oleynikov D. Resident involvement in laparoscopic procedures does not worsen clinical outcomes but may increase operative times and length of hospital stay. Surg Endosc. 2016 Sep;30(9):3783-91. doi: 10.1007/s00464-015-4674-z. Epub 2015 Nov 19.
PMID: 26585194
citation: Buddingh KT, Weersma RK, Savenije RA, van Dam GM, Nieuwenhuijs VB. Lower rate of major bile duct injury and increased intraoperative management of common bile duct stones after implementation of routine intraoperative cholangiography. J Am Coll Surg. 2011 Aug;213(2):267-74. doi: 10.1016/j.jamcollsurg.2011.03.004. Epub 2011 Apr 3.
PMID: 21459631
responsible party type: Principal Investigator
investigator affiliation: Jyväskylä Central Hospital
investigator full name: Olli Helminen
investigator title: M.D, Ph.D.
sharing ipd: No
provided document: 