“The purpose of these guidelines is to provide evidence-based recommendations for the use of intraoperative imaging modalities during laparoscopic cholecystectomy. We assessed surgical outcomes that were deemed to be important to both surgeons and patients by a panel of surgeons. Specifically, the imaging modalities investigated were contrast
intraoperative cholangiography (IOC), fluorescence imaging (FI) with indocyanine green (ICG), and laparoscopic ultrasound (LUS). The target audience for these guidelines
includes surgeons and patients. A patient–physician perspective was taken, so cost-effectiveness, resources requirements, and availability of said resources were not evaluated. These imaging modalities were primarily assessed in the context of the American healthcare system. Therefore, these recommendations may not apply in settings where the relevant
technology is not easily accessible.”

“Laparoscopic cholecystectomy is one of the most common abdominal operations performed in the United States. Injury to the common bile duct is a rare but dreaded complication, often requiring additional surgery or endoscopic intervention. Its occurrence has been increasing since the introduction and widespread adoption of laparoscopy
(0.4–1.5% of cases) compared to open cholecystectomy. Multiple factors may contribute to the risk of common bile duct injury, including the presence of acute inflammation and anatomical variability of the CBD. Strategies such as achieving the Critical View of Safety (CVS) were developed to mitigate this risk.”

“Intraoperative cholangiography (IOC) helps to clarify the biliary tree anatomy, detect common bile duct (CBD) stones, and may prevent or promptly detect BDI. However,
the use of routine (RC) or selective (SC) IOC remains controversial. Some authors have suggested that RC allows for early detection of BDI and repair in the same surgical
procedure, reducing morbidity and mortality.6–8 Also, IOC facilitates the detection and treatment of CBD stones, reducing potential complications and readmissions. In
contrast, opponents emphasize that RC often detects asymptomatic CBD stones leading to unnecessary procedures, increases operating time, costs, and exposes the surgical team and patients to radiation.”