Downloads
Download data is not yet available.
Abstract
This systematic review and meta-analysis aim to compare the outcomes and efficacy of open cholecystectomy (OC) and laparoscopic cholecystectomy (LC) for the management of symptomatic cholelithiasis. Cholecystectomy, the surgical removal of the gallbladder, is a common procedure performed to manage gallbladder diseases. Over the years, two primary approaches have been employed for cholecystectomy: open cholecystectomy (OC) and laparoscopic cholecystectomy (LC). This systematic review and meta-analysis aim to compare the clinical outcomes, safety, and efficacy of these two surgical techniques to provide evidence-based insights for clinical decision-making.
A comprehensive search was conducted across electronic databases to identify relevant studies comparing OC and LC in terms of postoperative complications, operative time, length of hospital stay, conversion rates, and overall patient satisfaction. Randomized controlled trials, prospective cohort studies, and retrospective studies meeting the inclusion criteria were included in the meta-analysis.
The meta-analysis of the selected studies demonstrates a significant reduction in operative time in the LC group compared to the OC group, indicating the advantages of laparoscopic techniques in terms of procedural efficiency. Moreover, LC exhibited lower rates of postoperative complications and a shorter length of hospital stay, highlighting its potential benefits in terms of improved patient outcomes and cost-effectiveness.
Subgroup analyses were conducted to explore the influence of factors such as surgeon experience, patient comorbidities, and specific complications on the comparative outcomes of OC and LC. Additionally, sensitivity analyses were performed to assess the robustness of the results and identify potential sources of heterogeneity.
Keywords:
Comparative study, open cholecystectomy, laparoscopic cholecystectomy
References
Ahmad G, Duffy JM, Phillips K, Watson A. Laparoscopic entry techniques. Cochrane Database syst Rev 2008:CD006583.
Ainsworth AP, Adamsen S, Rosenberg J. Surgery for acute cholecystitis in Denmark. Scand J Gastoenterol 2007;42:648-51.
Akyurek N, Salman B, Yuksel 0, et al. Management of acute calculous cholecystitis in highrisk patients: percutaneous cholecystotomy followed by early laparoscopic cholecystectomy. SurgLaparoscEndoscPercutan Tech 2005; 15:315-20.
Al Salamah SM. Outcome of laparoscopic cholecystectomy in acute cholecystitis. J Coli Physicians Surg Pak 2005; 15:400-3.
Aldouri AQ, Malik HZ, Waytt J, et al. The risk of gallbladder cancer from polyps in a large multiethnic series. Eur J SurgOncol 2009;35:48-51.
Asoglu 0, Ozmen V, Karanlik H, et al. Does the complication rate increase in laparoscopic cholecystectomy for acute cholecystitis? J LaparoendoscAdvSurg Tech A 2004; 14:81-6.
Avgerinos C, Kelgiorgi D, Touloumis Z, Baltatzi L, Dervenis C. One Thousand Laparoscopic Cholecystectomies in a Single Surgical Unit Using the "Critical View of Safety" Technique. J GastrointestSurg 2008.
Bektas H, 5chrem H, Winny M, Klempnauer J. Surgical treatment and outcome of iatrogenic bile duct lesions after cholecystectomy and the impact of different clinical classification systems. Br J surg 2007;94:1119-27.
Bertolin-Bernades R, Sabater-Orti L, Calvete-Chornet J, et al. Mild acute biliary pancreatitis vs cholelithiasis: are there differences in the rate of choledocholithiasis? J GastrointestSurg 2007; I I :875-9.
Bessa 55, Al-Fayoumi TA, Katri KM, Awad AT. Clipless laparoscopic cholecystectomy by ultrasonic dissection. J LaparoendoscAdvSurg Tech A 2008; 18: 593-8.