Highlights
- •Gallbladder carcinoma (GBC) is considered a highly lethal disease.
- •Laparoscopic surgery is non-inferior to open approach oncological outcomes.
- •Laparoscopic surgery is associated with fewer postoperative complications.
- •Laparoscopic surgery is comparable to open surgery in terms of overall survival.
Abstract
Background
This meta-analysis evaluates the safety and short-term oncological outcomes of laparoscopic
vs. open surgery for gallbladder carcinoma(GBC).
Methods
Meta-analysis was performed on laparoscopic(LG) and open group(OG) studies. Data for
survival outcomes were extracted from Kaplan-Meier curves and combined with Tierney's
method to estimate hazard ratios(HRs) and 95% CIs.
Results
There was no significant difference in overall survival(HR: 1.01), disease-free survival(HR:
0.84), 30-day mortality(RR:1.10), overall recurrence(RR:0.93), intraoperative gallbladder
violation(RR:1.17), operative time(WMD:8.32), number of patients receiving adjuvant
chemotherapy(RR:1.06) and blood transfusion(RR: 0.81). A significant difference was
seen in survival of T3 subgroup(HR:0.77) and number of lymph node dissections (LND)(WMD:
0.63) favoring OG, along with a decrease in postoperative complications(RR:0.65),
greater incidence of R0 resections(RR:1.04), lower volume of intraoperative blood
loss(WMD: 128.62), lower time in removing drainage tube(WMD: 1.35), shorter diet recovery
time(WMD: 1.88), shorter hospital stay(WMD: 3.51), lower incidence of 90-day mortality(RR:0.49)
favoring LG. A higher incidence of port-site recurrence(RR:1.99) was reported in LG.
Conclusion
Laparoscopic surgery is non-inferior to the open approach in terms of oncological
outcomes and has an improved rate of postoperative complications.
Keywords
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Article info
Publication history
Published online: January 10, 2023
Accepted:
January 8,
2023
Received in revised form:
December 26,
2022
Received:
November 15,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Elsevier Inc. All rights reserved.
