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Laparoscopic cholecystectomy versus mini-laparotomy cholecystectomy: a meta-analysis of randomised control trials

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Abstract

Aims

To use meta-analytic techniques to compare peri-operative and short term post-operative outcomes for patients undergoing cholecystectomy via the laparoscopic or mini-open approach.

Methods

Randomised control trials published between 1992 and 2005, cited in the literature of elective laparoscopic (LC) versus mini-open cholecystectomy (MoC) for symptomatic gallstone disease were included. End points evaluated were adverse events, operative and functional outcomes. A random effects meta-analytical model was used and between-study heterogeneity assessed. Subgroup analysis was performed to evaluate the difference in results for study size and quality and data reported from 2000.

Results

Nine randomised studies of 2032 patients were included in the analysis. There was considerable variation in the size and type of incision used for MoC in the studies. There was a significantly longer operating time for the LC group, by 14.14 minutes (95% CI 2.08, 26.19; p < 0.0001). Length of stay was reduced in the LC group by 0.37 days (95% CI −0.53, −0.21; p < 0.0001), with no significant heterogeneity for either outcome. For all other operative and post-operative outcomes, there was no significant difference between the two groups.

Conclusion

MoC appeared to have similar outcomes compared to LC, however LC did reduce the length of hospital stay. MoC is a viable and safe option for healthcare providers without the financial resources for laparoscopic equipment and appropriately trained surgical teams.

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Acknowledgments

The authors would like to thank Mr. Alex von Roon, Miss Rosamund Jacklin and Mr. Jesus Muñoz for their invaluable help in translating the foreign language papers included in this study.

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Authors and Affiliations

  1. Department of Biosurgery and Surgical Technology, Imperial College, St. Mary’s Hospital, London, UK

    Sanjay Purkayastha, Henry S. Tilney, Panagiotis Georgiou, Thanos Athanasiou, Paris P. Tekkis & Ara W. Darzi

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  1. Sanjay Purkayastha
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  2. Henry S. Tilney
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  3. Panagiotis Georgiou
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  4. Thanos Athanasiou
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  6. Ara W. Darzi
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Correspondence to Ara W. Darzi.

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Purkayastha, S., Tilney, H.S., Georgiou, P. et al. Laparoscopic cholecystectomy versus mini-laparotomy cholecystectomy: a meta-analysis of randomised control trials. Surg Endosc 21, 1294–1300 (2007). https://doi.org/10.1007/s00464-007-9210-3

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  • DOI: https://doi.org/10.1007/s00464-007-9210-3

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