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Laparoscopic vs. Open Cholecystectomy for Cirrhotic Patients: A Systematic Review and Meta-Analysis.
Journal: Hepato-gastroenterology
Year: 2011     Volume: 59     Issue: 118     Pages:
Author(s): Yao Cheng; Xian-Ze Xiong; Si-Jia Wu; Yi-Xin Lin; Nan-Sheng Cheng;

Abstract: Background/Aims: To compare the safety and effectiveness of laparoscopic cholecystectomy (LC) versus open cholecystectomy (OC) for cirrhotic patients. Methodology: The Cochrane Library, MEDLINE, Science Citation Index Expanded, EMBASE and CBM (Chinese Biomedical Database) were searched until August 2011 to indentify relevant and eligible studies. Results: Twenty three articles with 1316 cirrhotic patients were included. All patients were allocated to the LC group (n=694) or the OC group (n=622). They were primarily in Child-Pugh class A (n=957, 72.7%) and class B (n=343, 26.1%). Meta-analysis of 5 randomized controlled trials (n=284) indicated LC group was associated with the following advantages: significant lower surgery-related morbidity, less postoperative complications (e.g. incision hernia, wound infection), shorter hospital stay and less loss of blood. There were no significant differences in the intra-hospital mortality and total operative time between the two groups. Meta-analysis of 19 non-randomized studies (n=1082) showed similar results in favour of LC group. In addition, it showed significant lower intra-hospital mortality and less total operative time in the LC group than the OC group. Conclusions: LC is safe and offers various significant benefits over OC. Thus, it should be recommended for compensated cirrhotic patients.


Language: ENG

ISSN Print: 0172-6390

DOI: 10.5754/hge11688


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