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 18 February 2018

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News

Mini-open cholecystectomy is as safe as laparoscopic techniques

This month's Surgical Endoscopy shows the results of a meta-analysis comparing laparoscopic cholecystectomy with mini-laparotomy cholecystectomy.

News image

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Dr Ara Darzi and colleagues from the United Kingdom compared peri-operative and short term post-operative outcomes for patients undergoing cholecystectomy via the laparoscopic or mini-open approach.

The research team used meta-analytic techniques.

The researchers identified randomized control trials published between 1992 and 2005.

The trials were cited in the literature of elective laparoscopic versus mini-open cholecystectomy for symptomatic gallstone disease.

Operating times were 14 minutes longer for the laparoscopic group
Surgical Endoscopy

End points evaluated were adverse events, operative and functional outcomes.

The team used a random effects meta-analytical model and assessed between-study heterogeneity.

The team performed a subgroup analysis to evaluate the difference in results for study size and quality and data reported from 2000.

The researchers included 9 randomized studies of 2032 patients in the analysis.

There was considerable variation in the size, and type of incision used for mini-open cholecystectomy in the studies.

The team found there was a significantly longer operating time for the laparoscopic group, by 14 minutes.

The research team noted that length of stay was reduced in the laparoscopic group by 0.4 days, with no significant heterogeneity for either outcome.

The team found for all other operative and post-operative outcomes, there was no significant difference between the 2 groups.

Dr Darzi's team concluded, "Mini-open cholecystectomy appeared to have similar outcomes compared to laparoscopic, however laparoscopic did reduce the length of hospital stay."

"Mini-open cholecystectomy is a viable and safe option for healthcare providers without the financial resources for laparoscopic equipment and appropriately trained surgical teams."

Surg Endoscopy 2007: 21(8): 1294-1300
27 August 2007

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