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Meta-Analysis
. 2006 Oct 18;2006(4):CD006229.
doi: 10.1002/14651858.CD006229.

Laparoscopic versus small-incision cholecystectomy for patients with symptomatic cholecystolithiasis

F Keus  1 , J A F de Jong, H G Gooszen, C J H M van Laarhoven
Affiliations
Meta-Analysis

Laparoscopic versus small-incision cholecystectomy for patients with symptomatic cholecystolithiasis

F Keus et al. Cochrane Database Syst Rev. .

Abstract

Background: Cholecystectomy is one of the most frequently performed operations. Open cholecystectomy has been the gold standard for over 100 years. Small-incision cholecystectomy is a less frequently used alternative. Laparoscopic cholecystectomy was introduced in the 1980s.

Objectives: To compare the beneficial and harmful effects of laparoscopic versus small-incision cholecystectomy for patients with symptomatic cholecystolithiasis.

Search strategy: We searched TheCochrane Hepato-Biliary Group Controlled Trials Register (6 April 2004), The Cochrane Library (Issue 1, 2004), MEDLINE (1966 to January 2004), EMBASE (1980 to January 2004), Web of Science (1988 to January 2004), and CINAHL (1982 to January 2004) for randomised trials.

Selection criteria: All published and unpublished randomised trials in patients with symptomatic cholecystolithiasis comparing any kind of laparoscopic cholecystectomy versus small-incision or other kind of minimal incision open cholecystectomy. No language limitations were applied.

Data collection and analysis: Two authors independently performed selection of trials and data extraction. The methodological quality of the generation of the allocation sequence, allocation concealment, blinding, and follow-up was evaluated to assess bias risk. Analyses were based on the intention-to-treat principle. Authors were requested additional information in case of missing data. Sensitivity and subgroup analyses were performed if appropriate.

Main results: Thirteen trials randomised 2337 patients. Methodological quality was relatively high considering the four quality criteria. Total complications of laparoscopic and small-incision cholecystectomy are high: 26.6% versus 22.9%. Total complications (risk difference, random-effects -0.01, 95% confidence interval (CI) -0.07 to 0.05), hospital stay (weighted mean difference (WMD), random-effects -0.72 days, 95% CI -1.48 to 0.04), and convalescence were not significantly different. High-quality trials show a quicker operative time for small-incision cholecystectomy (WMD, high-quality trials 'blinding', random-effects 16.4 minutes, 95% CI 8.9 to 23.8) while low-quality trials show no significant difference.

Authors' conclusions: Laparoscopic and small-incision cholecystectomy seem to be equivalent. No differences could be observed in mortality, complications, and postoperative recovery. Small-incision cholecystectomy has a significantly shorter operative time. Complications in elective cholecystectomy are prevalent.

PubMed Disclaimer

Conflict of interest statement

We (FK, HG, CL) are the coordinating authors of an unpublished trial (Keus 2006), which will be published in the near future.

Figures

1
1
Methodological quality graph: review authors' judgements about each methodological quality item presented as percentages across all included studies.
2
2
Methodological quality summary: review authors' judgements about each methodological quality item for each included study.
3
3
Funnel plot on laparoscopic versus small‐incision cholecystectomy regarding generation of the allocation sequence considering total complications, including 95% confidence interval lines. There is some suspicion of bias considering the absence (in the lower right part of the figure) of small trials favoring the small‐incision technique.
4
4
Funnel plot on laparoscopic versus small‐incision cholecystectomy regarding generation of the allocation sequence considering conversions, including 95% confidence interval lines. No arguments for bias.
5
5
Funnel plot on laparoscopic versus small‐incision cholecystectomy regarding generation of the allocation sequence considering operative time, including 95% confidence interval lines. No arguments for bias.
6
6
Funnel plot on laparoscopic versus small‐incision cholecystectomy regarding generation of the allocation sequence considering hospital stay, including 95% confidence interval lines. No arguments for bias.
1.1
1.1. Analysis
Comparison 1 LC versus SIC ‐ high‐quality and low‐quality trials regarding generation of the allocation sequence, Outcome 1 Mortality.
1.2
1.2. Analysis
Comparison 1 LC versus SIC ‐ high‐quality and low‐quality trials regarding generation of the allocation sequence, Outcome 2 Intra‐operative complications.
1.3
1.3. Analysis
Comparison 1 LC versus SIC ‐ high‐quality and low‐quality trials regarding generation of the allocation sequence, Outcome 3 Minor complications.
1.4
1.4. Analysis
Comparison 1 LC versus SIC ‐ high‐quality and low‐quality trials regarding generation of the allocation sequence, Outcome 4 Severe complications (without bile duct injuries).
1.5
1.5. Analysis
Comparison 1 LC versus SIC ‐ high‐quality and low‐quality trials regarding generation of the allocation sequence, Outcome 5 Bile duct injuries.
1.6
1.6. Analysis
Comparison 1 LC versus SIC ‐ high‐quality and low‐quality trials regarding generation of the allocation sequence, Outcome 6 Total complications.
1.7
1.7. Analysis
Comparison 1 LC versus SIC ‐ high‐quality and low‐quality trials regarding generation of the allocation sequence, Outcome 7 Conversions.
1.8
1.8. Analysis
Comparison 1 LC versus SIC ‐ high‐quality and low‐quality trials regarding generation of the allocation sequence, Outcome 8 Operative time (minutes).
1.9
1.9. Analysis
Comparison 1 LC versus SIC ‐ high‐quality and low‐quality trials regarding generation of the allocation sequence, Outcome 9 Hospital stay (days).
1.10
1.10. Analysis
Comparison 1 LC versus SIC ‐ high‐quality and low‐quality trials regarding generation of the allocation sequence, Outcome 10 Convalescence: work leave (days).
1.11
1.11. Analysis
Comparison 1 LC versus SIC ‐ high‐quality and low‐quality trials regarding generation of the allocation sequence, Outcome 11 Convalescence: normal activity (at home) (days).
2.1
2.1. Analysis
Comparison 2 LC versus SIC ‐ high‐quality and low‐quality trials regarding allocation concealment, Outcome 1 Mortality.
2.2
2.2. Analysis
Comparison 2 LC versus SIC ‐ high‐quality and low‐quality trials regarding allocation concealment, Outcome 2 Intra‐operative complications.
2.3
2.3. Analysis
Comparison 2 LC versus SIC ‐ high‐quality and low‐quality trials regarding allocation concealment, Outcome 3 Minor complications.
2.4
2.4. Analysis
Comparison 2 LC versus SIC ‐ high‐quality and low‐quality trials regarding allocation concealment, Outcome 4 Severe complications (without bile duct injuries).
2.5
2.5. Analysis
Comparison 2 LC versus SIC ‐ high‐quality and low‐quality trials regarding allocation concealment, Outcome 5 Bile duct injuries.
2.6
2.6. Analysis
Comparison 2 LC versus SIC ‐ high‐quality and low‐quality trials regarding allocation concealment, Outcome 6 Total complications.
2.7
2.7. Analysis
Comparison 2 LC versus SIC ‐ high‐quality and low‐quality trials regarding allocation concealment, Outcome 7 Conversions.
2.8
2.8. Analysis
Comparison 2 LC versus SIC ‐ high‐quality and low‐quality trials regarding allocation concealment, Outcome 8 Operative time (minutes).
2.9
2.9. Analysis
Comparison 2 LC versus SIC ‐ high‐quality and low‐quality trials regarding allocation concealment, Outcome 9 Hospital stay (days).
2.10
2.10. Analysis
Comparison 2 LC versus SIC ‐ high‐quality and low‐quality trials regarding allocation concealment, Outcome 10 Convalescence: work leave (days).
2.11
2.11. Analysis
Comparison 2 LC versus SIC ‐ high‐quality and low‐quality trials regarding allocation concealment, Outcome 11 Convalescence: normal activity (at home) (days).
3.1
3.1. Analysis
Comparison 3 LC versus SIC ‐ high‐quality and low‐quality trials regarding blinding, Outcome 1 Mortality.
3.2
3.2. Analysis
Comparison 3 LC versus SIC ‐ high‐quality and low‐quality trials regarding blinding, Outcome 2 Intra‐operative complications.
3.3
3.3. Analysis
Comparison 3 LC versus SIC ‐ high‐quality and low‐quality trials regarding blinding, Outcome 3 Minor complications.
3.4
3.4. Analysis
Comparison 3 LC versus SIC ‐ high‐quality and low‐quality trials regarding blinding, Outcome 4 Severe complications (without bile duct injuries).
3.5
3.5. Analysis
Comparison 3 LC versus SIC ‐ high‐quality and low‐quality trials regarding blinding, Outcome 5 Bile duct injuries.
3.6
3.6. Analysis
Comparison 3 LC versus SIC ‐ high‐quality and low‐quality trials regarding blinding, Outcome 6 Total complications.
3.8
3.8. Analysis
Comparison 3 LC versus SIC ‐ high‐quality and low‐quality trials regarding blinding, Outcome 8 Operative time (minutes).
3.9
3.9. Analysis
Comparison 3 LC versus SIC ‐ high‐quality and low‐quality trials regarding blinding, Outcome 9 Hospital stay (days).
3.10
3.10. Analysis
Comparison 3 LC versus SIC ‐ high‐quality and low‐quality trials regarding blinding, Outcome 10 Convalescence: work leave (days).
3.11
3.11. Analysis
Comparison 3 LC versus SIC ‐ high‐quality and low‐quality trials regarding blinding, Outcome 11 Convalescence: normal activity (at home) (days).
4.1
4.1. Analysis
Comparison 4 LC versus SIC ‐ high‐quality and low‐quality trials regarding follow‐up, Outcome 1 Mortality.
4.2
4.2. Analysis
Comparison 4 LC versus SIC ‐ high‐quality and low‐quality trials regarding follow‐up, Outcome 2 Intra‐operative complications.
4.3
4.3. Analysis
Comparison 4 LC versus SIC ‐ high‐quality and low‐quality trials regarding follow‐up, Outcome 3 Minor complications.
4.4
4.4. Analysis
Comparison 4 LC versus SIC ‐ high‐quality and low‐quality trials regarding follow‐up, Outcome 4 Severe complications (without bile duct injuries).
4.5
4.5. Analysis
Comparison 4 LC versus SIC ‐ high‐quality and low‐quality trials regarding follow‐up, Outcome 5 Bile duct injuries.
4.6
4.6. Analysis
Comparison 4 LC versus SIC ‐ high‐quality and low‐quality trials regarding follow‐up, Outcome 6 Total complications.
4.7
4.7. Analysis
Comparison 4 LC versus SIC ‐ high‐quality and low‐quality trials regarding follow‐up, Outcome 7 Conversions.
4.8
4.8. Analysis
Comparison 4 LC versus SIC ‐ high‐quality and low‐quality trials regarding follow‐up, Outcome 8 Operative time (minutes).
4.9
4.9. Analysis
Comparison 4 LC versus SIC ‐ high‐quality and low‐quality trials regarding follow‐up, Outcome 9 Hospital stay (days).
4.10
4.10. Analysis
Comparison 4 LC versus SIC ‐ high‐quality and low‐quality trials regarding follow‐up, Outcome 10 Convalescence: work leave (days).
4.11
4.11. Analysis
Comparison 4 LC versus SIC ‐ high‐quality and low‐quality trials regarding follow‐up, Outcome 11 Convalescence: normal activity (at home) (days).
5.1
5.1. Analysis
Comparison 5 LC versus SIC ‐ sensitivity and subgroup analyses, Outcome 1 Sensitivity analysis 1: Assuming zero mortality in nonreporting trials.
5.2
5.2. Analysis
Comparison 5 LC versus SIC ‐ sensitivity and subgroup analyses, Outcome 2 Sensitivity analysis 2: Assuming zero conversions in nonreporting trials.
5.3
5.3. Analysis
Comparison 5 LC versus SIC ‐ sensitivity and subgroup analyses, Outcome 3 Sensitivity analysis 3: Imputing medians and standard deviations for missing data in operative time (minutes).
5.4
5.4. Analysis
Comparison 5 LC versus SIC ‐ sensitivity and subgroup analyses, Outcome 4 Sensitivity analysis 4: Imputing medians and standard deviations for missing data in hospital stay (days).
5.5
5.5. Analysis
Comparison 5 LC versus SIC ‐ sensitivity and subgroup analyses, Outcome 5 Sensitivity analysis 5: Imputing medians and standard deviations for missing data in convalescence: work leave.
5.6
5.6. Analysis
Comparison 5 LC versus SIC ‐ sensitivity and subgroup analyses, Outcome 6 Sensitivity analysis 6: Imputing medians and standard deviations for missing data in normal activity.
5.7
5.7. Analysis
Comparison 5 LC versus SIC ‐ sensitivity and subgroup analyses, Outcome 7 Sensitivity analysis 7: Omitting outlier Srivastava in minor complications.
5.8
5.8. Analysis
Comparison 5 LC versus SIC ‐ sensitivity and subgroup analyses, Outcome 8 Sensitivity analysis 8: Omitting outlier Srivastava in total complications.
5.9
5.9. Analysis
Comparison 5 LC versus SIC ‐ sensitivity and subgroup analyses, Outcome 9 Sensitivity analysis 9: Omitting outlier Grande in hospital stay (days).
5.10
5.10. Analysis
Comparison 5 LC versus SIC ‐ sensitivity and subgroup analyses, Outcome 10 Sensitivity analysis 10: Total complications including Redmond.
5.11
5.11. Analysis
Comparison 5 LC versus SIC ‐ sensitivity and subgroup analyses, Outcome 11 Sensitivity analysis 11: Operative time (minutes) including Redmond.
5.12
5.12. Analysis
Comparison 5 LC versus SIC ‐ sensitivity and subgroup analyses, Outcome 12 Subgroup analysis 1: Influence antibiotic prophylaxis on total complications.
5.13
5.13. Analysis
Comparison 5 LC versus SIC ‐ sensitivity and subgroup analyses, Outcome 13 Subgroup analysis 2: Influence surgical experience on total complications.
5.14
5.14. Analysis
Comparison 5 LC versus SIC ‐ sensitivity and subgroup analyses, Outcome 14 Subgroup analysis 3: Influence cholangiography on operative time (minutes).
5.15
5.15. Analysis
Comparison 5 LC versus SIC ‐ sensitivity and subgroup analyses, Outcome 15 Subgroup analysis 4: Influence surgical experience on operative time (minutes).
5.16
5.16. Analysis
Comparison 5 LC versus SIC ‐ sensitivity and subgroup analyses, Outcome 16 Subgroup analysis 5: Influence antibiotic prophylaxis on hospital stay (days).
5.17
5.17. Analysis
Comparison 5 LC versus SIC ‐ sensitivity and subgroup analyses, Outcome 17 Subgroup analysis 6: Influence surgical experience on hospital stay (days).
5.18
5.18. Analysis
Comparison 5 LC versus SIC ‐ sensitivity and subgroup analyses, Outcome 18 Subgroup analysis 7: Influence cholangiography on bile duct injuries.
See this image and copyright information in PMC

References

References to studies included in this review

Barkun 1992 {published data only}
    1. Barkun JS, Barkun AN, Sampalis JS, Fried G, Taylor B, Wexler MJ, et al. Randomized controlled trial of laparoscopic versus mini cholecystectomy. Lancet 1992;340(7):1116‐9. - PubMed
    1. Barkun JS, Caro JJ, Barkun AN, Trindade E. Cost‐effectiveness of laparoscopic and mini‐cholecystectomy in a prospective randomized trial. Surgical Endoscopy 1995;9(11):1221‐4. - PubMed
Bruce 1999 {published data only}
    1. Bruce DM, Smith M, Walker CBJ, Heys SD, Binnie NR, Gough DB, et al. Minimal access surgery for cholelithiasis induces an attenuated acute phase response. American Journal of Surgery 1999;178(3):232‐4. - PubMed
    1. Walker CB, Bruce DM, Heys SD, Gough DB, Binnie NR, Eremin O. Minimal modulation of lymphocyte and natural killer cell subsets following minimal access surgery. American Journal of Surgery 1999;177(1):48‐54. - PubMed
Coelho 1993 {published data only}
    1. Coelho JCU, DeAraujo RPM, Marchesini JB, Coelho ICMM, DeAraujo LRR. Pulmonary‐function after cholecystectomy performed through Kocher incision, a mini‐incision, and laparoscopy. World Journal of Surgery 1993;17(4):544‐6. - PubMed
Grande 2002 {published data only}
    1. Grande M, Tucci GF, Adorisio O, Barini A, Rulli F, Neri A, et al. Systemic acute‐phase response after laparoscopic and open cholecystectomy. Surgical Endoscopy 2002;16(2):313‐6. - PubMed
Keus 2006 {unpublished data only}
    1. Keus E, Laarhoven CJHM. Small‐incision versus laparoscopic cholecystectomy: blind RCT. Unpublished data.
Kunz 1992 {published data only}
    1. Kunz R. Laparoscopic versus mini‐lap‐cholecystectomy. Results of a prospective randomized study [Cholezystektomie ‐ laparoskopische versus mini‐lap‐Cholezystektomie. Ergebnisse einer prospektiv randomisierten Studie]. Langenbecks Archiv fur Chirurgie 1993;Suppl Kongressbericht:84‐8. - PubMed
    1. Kunz R, Berger R, Beger HG. Laparoscopic versus conventional cholecystectomy [Laparoskopische versus konventionelle Cholezystektomie]. Minimal Invasive Chirurgie 1993;2(Suppl 1):2.
    1. Kunz R, Orth K, Vogel J, Steinacker JM, Meitinger A, Bruckner U, et al. Laparoscopic cholecystectomy versus mini‐lap cholecystectomy ‐ results of a prospective randomized study [Laparoskopische Cholecystektomie versus mini‐lap‐Cholecystektomie ‐ Ergebnisse einer prospektiven, randomisierten Studie]. Chirurg 1992;63(4):291‐5. - PubMed
    1. Schutze F, Osswald C, Berger D, Kunz R, Beger HG. Peri‐ and postoperative mediator release: laparoscopic versus laparotomic cholecystectomy [Peri‐ und postoperative Mediatorenfreisetzung: laparoskopische versus laparotomische Cholecystektomie]. Langenbecks Archiv fur Chirurgie 1993;Suppl 1 Forumband:55‐8.
Majeed 1996 {published data only}
    1. Calvert NW, Troy GP, Johnson AG. Laparoscopic cholecystectomy: a good buy? A cost comparison with small‐incision (mini) cholecystectomy. European Journal of Surgery 2000;166(10):782‐6. - PubMed
    1. Majeed AW, Troy G, Nicholl JP, Smythe A, Reed MWR, Stoddard CJ, et al. Randomised, prospective, single‐blind comparison of laparoscopic versus small‐incision cholecystectomy. Lancet 1996;347(9007):989‐94. - PubMed
    1. Squirrell DM, Majeed AW, Troy G, Peacock JE, Nicholl JP, Johnson AG. A randomized, prospective, blinded comparison of postoperative pain, metabolic response, and perceived health after laparoscopic and small incision cholecystectomy. Surgery 1998;123(5):485‐95. - PubMed
McGinn 1995 {published data only}
    1. Faux JW, Terzi C, McGinn FP. Prospective randomized trial of mini‐cholecystectomy versus laparoscopic cholecystectomy: a single surgeon study. British Journal of Surgery 1998;85(suppl 1):77.
    1. McGinn FP, Miles AJG, Uglow M, Ozmen M, Terzi C, Humby M. Randomized trial of laparoscopic cholecystectomy and mini‐cholecystectomy. British Journal of Surgery 1995;82(10):1374‐7. - PubMed
McMahon 1994 {published data only}
    1. McMahon AJ, Baxter JN, Anderson JR, Ramsay G, Galloway D, Russell IT, et al. Assessment of pain after laparoscopic cholecystectomy and minicholecystectomy [abstract]. British Journal of Surgery 1992;79(11):1224.
    1. McMahon AJ, Baxter JN, Anderson JR, Ramsay G, Galloway D, Sunderland G, et al. Pain and pulmonary‐function after laparoscopic and mini‐cholecystectomy ‐ a randomized trial [abstract]. Gastroenterology 1993;104(4):A370.
    1. McMahon AJ, Baxter JN, Anderson JR, Ramsay G, Galloway D, Sunderland G, et al. Postoperative pain and analgesia requirement after laparoscopic and mini‐cholecystectomy ‐ a prospective randomized trial [abstract]. Gut 1992;33(2):S63.
    1. McMahon AJ, Baxter JN, Kenny G, O'Dwyer PJ. Ventilatory and blood‐gas changes during laparoscopic and open cholecystectomy. British Journal of Surgery 1993;80(10):1252‐4. - PubMed
    1. McMahon AJ, Baxter JN, Kenny G, O'Dwyer PJ. Ventilatory changes during laparoscopic and open cholecystectomy: a randomized trial [abstract]. British Journal of Surgery 1993;80(5):647. - PubMed
Redmond 1994 {published data only}
    1. Redmond HP, Watson RWG, Houghton T, Condron C, Watson RGK, Bouchier‐Hayes D. Immune function in patients undergoing open vs laparoscopic cholecystectomy. Archives of Surgery 1994;129(12):1240‐6. - PubMed
Ros 2001 {published data only}
    1. Nilsson E, Ros A, Rahmqvist M, Backman K, Carlsson P. Cholecystectomy: costs and health‐related quality of life: a comparison of two techniques. International Journal for Quality in Health Care 2004;16(6):473‐82. - PubMed
    1. Ros A, Gustafsson L, Krook H, Nordgren CE, Thorell A, Wallin G, et al. Laparoscopic cholecystectomy versus mini‐laparotomy cholecystectomy: a prospective, randomized, single‐blind study. Annals of Surgery 2001;234(6):741‐9. - PMC - PubMed
Secco 2002 {published data only}
    1. Secco GB, Cataletti M, Bonfante P, Baldi E, Davini MD, Biasotti B, et al. Laparoscopic versus mini‐cholecystectomy: analysis of hospital costs and social costs in a prospective randomized study [Video‐colecistectomia versus mini‐colecistectomia: analisi dei costi ospedalieri e dei costi sociali in uno studio prospettico randomizzato]. Chirurgia Italiana 2002;54(5):685‐92. - PubMed
Srivastava 2001 {published data only}
    1. Srinivas G, Srivastava A, Misra MC, Pandav CS. Cost‐effectiveness analysis: laparoscopic versus minilaparotomy cholecystectomy for gallstone disease [abstract]. Clinical Economics 1998;51(Suppl 1):33S. - PubMed
    1. Srivastava A, Srinivas G, Misra MC, Pandav CS, Seenu V, Goyal A. Cost‐effectiveness analysis of laparoscopic versus minilaparotomy cholecystectomy for gallstone disease ‐ A randomized trial. International Journal of Technology Assessment in Health Care 2001;17(4):497‐502. - PubMed
Tate 1993 {published data only}
    1. Tate JJ, Lau WY, Leung KL, Li AK. Laparoscopic versus mini‐incision cholecystectomy. Lancet 1993;341(8854):1214‐5. - PubMed

References to studies excluded from this review

Agnifili 1993 {published data only}
    1. Agnifili A, Guadagni S, Ibi I, Verzaro R, Gola P, Gianfelice F, et al. Pulmonary function after laparoscopic and open cholecystectomy [abstract]. British Journal of Surgery 1993;80(Suppl):S44.
    1. Agnifili A, Ibi I, Guadagni S, Verzaro R, Gianfelice F, Mancini E, et al. Perioperative pain and stress: a comparison between video laparoscopic cholecystectomy and "open" cholecystectomy [Dolore e stress perioperatori: confronto tra videolaparocolecistectomia e colecistectomia 'open']. Il Giornale di Chirurgia 1993;14(7):344‐8. - PubMed
    1. Agnifili A, Verzaro R, Colangeli A, Debernardinis G, Ibi I. Perioperative pulmonary‐function, pain and stress‐response after cholecystectomy performed via laparotomy or laparoscopy ‐ comparison between laparoscopy and laparotomy. Minimally Invasive Therapy & Allied Technologies 1993;2(6):283‐8.
    1. Ibi I, Agnifili A, Verzaro R, Carducci G, Marino M, Mancini E, et al. Respiratory function, postoperative pain and stress following videolaparocholecystectomy and traditional cholecystectomy [Funzione respiratoria, dolore e stress perioperatori dopo videolaparocolecistectomia e colecistectomia tradizionale]. Chirurgia 1994;7:97‐102.
Al Tameem 1995 {published data only}
    1. Al Tameem M. Mini‐laparotomy cholecystectomy: splitting versus partial and whole transection of the rectus abdominis muscle. Saudi Medical Journal 1995;16(2):113‐5.
Alexander 1997 {published data only}
    1. Alexander JI. Pain after laparoscopy. British Journal of Anaesthesia 1997;79(3):369‐78. - PubMed
Allen 2002 {published data only}
    1. Allen JW, Polk HC. A study of added costs of laparoscopic cholecystectomy based on surgery preference cards. American Surgeon 2002;68(5):474‐6. - PubMed
Alponat 2002 {published data only}
    1. Alponat A, Cubukcu A, Gonullu N, Canturk Z, Ozbay O. Is minisite cholecystectomy less traumatic? Prospective randomized study comparing minisite and conventional laparoscopic cholecystectomies. World Journal of Surgery 2002;26(12):1437‐40. - PubMed
Anonymous 1995 {published data only}
    1. Disposables targeted to reduce lap chole cost. OR Manager 1995;11(11):14.
Assalia 1993 {published data only}
    1. Assalia A, Schein M, Kopelman D, Hashmonai M. Minicholecystectomy vs conventional cholecystectomy ‐ a prospective randomized trial ‐ implications in the laparoscopic era. World Journal of Surgery 1993;17(6):755‐9. - PubMed
Assalia 1997a {published data only}
    1. Assalia A, Kopelman D, Hashmonai M. Emergency minilaparotomy cholecystectomy for acute cholecystitis: prospective randomized trial ‐ implications for the laparoscopic era. World Journal of Surgery 1997;21(5):534‐9. - PubMed
Bablekos 2003 {published data only}
    1. Bablekos GD, Roussou T, Rasmussen T, Vassiliou MP, Behrakis PK. Postoperative changes on pulmonary function after laparoscopic and open cholecystectomy. Hepato‐Gastroenterology 2003;50(53):1193‐200. - PubMed
Barkun 1993 {published data only}
    1. Barkun JS, Barkun AN, Meakins JL, Bailar J, Battista RN, Brassard R, et al. Laparoscopic versus open cholecystectomy ‐ the Canadian experience. American Journal of Surgery 1993;165(4):455‐8. - PubMed
Baxter 1992 {published data only}
    1. Baxter JN, O'Dwyer PJ. Laparoscopic or minilaparotomy cholecystectomy?. BMJ (Clinical Research Ed.) 1992;304(6826):559‐60. - PMC - PubMed
Bellon 1998 {published data only}
    1. Bellon JM, Manzano L, Bernardos L, Ga Honduvilla N, Larrad A, Bujan J, et al. Cytokine levels after open and laparoscopic cholecystectomy. European Surgical Research 1997;29(1):27‐34. - PubMed
    1. Bellon JM, Manzano L, Larrad A, Honduvilla GN, Bujan J, Alvarez‐Mon M. Endocrine and immune response to injury after open and laparoscopic cholecystectomy. International Surgery 1998;83(1):24‐7. - PubMed
Berggren 1994 {published data only}
    1. Berggren U, Gordh T, Grama D, Haglund U, Rastad J, Arvidsson D. Laparoscopic versus open cholecystectomy ‐ hospitalization, sick leave, analgesia and trauma responses. British Journal of Surgery 1994;81(9):1362‐5. - PubMed
Bernard 1994 {published data only}
    1. Bernard A, Aho S, Charvet‐Protat S, Durieux P. Evaluation of laparoscopy in intestinal surgery and gynecological surgery and its economic implications (Three reports). Paris: Agence Nationale pour le Developpement de l'Evaluation Medicale (ANAES) 1994.
Bigard 1995 {published data only}
    1. Bigard MA, Bernard A, Cassan P, Deplantez J, Fagniez PL, Fortier B, et al. Indications and methods of cholecystectomy in treatment of gallstones [Indications et modalites de la cholecystectomie dans la lithiase vesiculaire]. Gastroenterologie Clinique et Biologique 1995;19(8‐9):707‐17. - PubMed
Blanc‐Louvry 2000 {published data only}
    1. Blanc‐Louvry I, Coquerel A, Koning E, Maillot C, Ducrotte P. Operative stress response is reduced after laparoscopic compared to open cholecystectomy ‐ The relationship with postoperative pain and ileus. Digestive Diseases and Sciences 2000;45(9):1703‐13. - PubMed
Blomstedt 1972 {published data only}
    1. Blomstedt B, Welin‐Berger T. Incisional hernias. A comparison between midline, oblique and transrectal incisions. Acta Chirurgica Scandinavica 1972;138(3):275‐8. - PubMed
Bolke 2000 {published data only}
    1. Bolke E, Jehle PM, Nothnagel B, Seidelmann M, Storck M, Orth K. A prospective randomised study on endotoxaemia, mediator release and morbidity in conventional, compared with laparoscopic cholecystectomy. Minimally Invasive Therapy & Allied Technologies 2000;9(6):387‐92.
Bukan 2004 {published data only}
    1. Bukan MH, Bukan N, Kaymakcioglu N, Tufan T. Effects of open vs. laparoscopic cholecystectomy on oxidative stress. Tohoku Journal of Experimental Medicine 2004;202(1):51‐6. - PubMed
Byrne 1994 {published data only}
    1. Byrne J, Timon D, Armstrong C, Horgan PG, Quill DS. A comparison of analgesic requirements and pulmonary‐function in open versus laparoscopic cholecystectomy. Minimally Invasive Therapy & Allied Technologies 1994;3(1):3‐6.
Calland 2001 {published data only}
    1. Calland JF, Tanaka K, Foley E, Bovbjerg VE, Markey DW, Blome S, et al. Outpatient laparoscopic cholecystectomy: patient outcomes after implementation of a clinical pathway. Annals of Surgery 2001;233(5):704‐15. - PMC - PubMed
Caplan 1999 {published data only}
    1. Caplan G, Board N, Paten A, Tazelaar MJ, Crowe P, Yap SJ, et al. Decreasing lengths of stay: the cost to the community. Australian and New Zealand Journal of Surgery 1999;69(6):433‐7. - PubMed
Champault 2002 {published data only}
    1. Champault A, Vons C, Dagher I, Amerlinck S, Franco D. Low‐cost laparoscopic cholecystectomy. British Journal of Surgery 2002;89(12):1602‐7. - PubMed
Charlo 1995 {published data only}
    1. Charlo DT, Fernandez MM, Tejido SC. A cost analysis of laparoscopic cholecystectomy compared with the open technic [Analisis de costes de la colecistectomia laparoscopica en comparacion con la abierta]. Revista Espanola de Enfermedades Digestivas 1995;87(6):449‐52. - PubMed
Chaudhary 1999 {published data only}
    1. Chaudhary D, Verma GR, Gupta R, Bose SM, Ganguly NK. Comparative evaluation of the inflammatory mediators in patients undergoing laparoscopic versus conventional cholecystectomy. Australian and New Zealand Journal of Surgery 1999;69(5):369‐72. - PubMed
Chumillas 1998 {published data only}
    1. Chumillas MS, Ponce JL, Delgado F, Viciano V. Pulmonary function and complications after laparoscopic cholecystectomy. European Journal of Surgery 1998;164(6):433‐7. - PubMed
Clezy 1996 {published data only}
    1. Clezy JKA. Randomized trial of laparoscopic cholecystectomy and mini‐cholecystectomy [letter]. British Journal of Surgery 1996;83(2):279. - PubMed
Coelho 1992 {published data only}
    1. Coelho JC, Marchesini JB, Campos AC, Camargo CA, Griilo MA, Campos GM. Cholecystectomy through mini‐laparotomy [Colecistectomia por mini‐laparotomia]. Revista Brasileira de Cirurgia 1992;19:213‐5.
Coelho 1992a {published data only}
    1. Coelho JC, Campos GM, Matias JE. Cholecystectomy through mini‐incision and through classic subcostal incision: a prospective randomized study [Colecistectomia por mini‐incisao subcostal classica: estudo prospectivo randomizado]. Revista Brasileira de Cirurgia 1992;82:67‐9.
Coskun 2000 {published data only}
    1. Coskun I, Hatipoglu AR, Topaloglu A, Yoruk Y, Yalcinkaya S, Caglar T. Laparoscopic versus open cholecystectomy: effect on pulmonary function tests. Hepato‐Gastroenterology 2000;47(32):341‐2. - PubMed
Da Costa 1995 {published data only}
    1. Costa ML, Qureshi MA, Brindley NM, Burke PE, Grace PA, Bouchier‐Hayes D. Normal inspiratory muscle strength is restored more rapidly after laparoscopic cholecystectomy. Annals of the Royal College of Surgeons of England 1995;77:252‐5. - PMC - PubMed
Dauleh 1995 {published data only}
    1. Dauleh MI, Rahman S, Townell NH. Open versus laparoscopic cholecystectomy: a comparison of postoperative temperature. Journal of the Royal College of Surgeons of Edinburgh 1995;40(2):116‐8. - PubMed
Decker 1993 {published data only}
    1. Decker D, Schondorf M, Decker P, Bidlingmaier F, Hirner A, Rucker A. Evaluation of tissue trauma with the help of activation markers on the cell membrane of leukocytes. A comparison: laparoscopic versus convertional cholecystectomy. Langenbecks Archiv fur Chirurgie 1993;Suppl 1 Forumband:49‐53.
Delogu 1999 {published data only}
    1. Delogu G, Famularo G, Luzzi S, Rubcich P, Giardina A, Masciangelo R, et al. General anesthesia mode does not influence endocrine or immunologic profile after open or laparoscopic cholecystectomy. Surgical Laparoscopy, Endoscopy & Percutaneous Techniques 1999;9(5):326‐32. - PubMed
Demirer 2000 {published data only}
    1. Demirer S, Karadayi K, Simsek S, Erverdi N, Bumin C. Comparison of postoperative acute‐phase reactants in patients who underwent laparoscopic vs open cholecystectomy: a randomized study. Journal of Laparoendoscopic & Advanced Surgical Techniques ‐ Part A 2000;10(5):249‐52. - PubMed
Dionigi 1994 {published data only}
    1. Dionigi R, Dominioni L, Benevento A, Giudice G, Cuffari S, Bordone N, et al. Effects of surgical trauma of laparoscopic vs open cholecystectomy. Hepato‐Gastroenterology 1994;41(5):471‐6. - PubMed
    1. Dominioni L, Benevento A, Carcano G, Chiappa A, Dionigi R. Acute‐phase response after laparoscopic and open cholecystectomy [abstract]. British Journal of Surgery 1993;80:S44.
Dohrmann 1993 {published data only}
    1. Dohrmann A, Richthammer M, Jochims J, Stremmel W. Postoperative changes in pulmonary function after laparoscopic versus conventional cholecystectomy ‐ a prospective study [Postoperative Veranderungen der Lungenfunktion nach laparoskopischer versus konventioneller Cholezystektomie ‐ eine prospektive Studie]. Minimal Invasive Chirurgie 1993;2(Suppl 1):19‐20.
Eickhoff 1997 {published data only}
    1. Eickhoff H, Milheiro A, Manso LC, Castro‐Sousa F. Alterations in respiratory function after cholecystectomy ‐ open versus laparoscopic cholecystectomy [Veranderungen der Lungenfunktion nach Cholezystektomie ‐ offene versus laparoskopische Cholezystektomie]. Langenbecks Archiv fur Chirurgie, Suppl II (Kongressbericht 1997) 1997;114:1105‐7. - PubMed
Engin 1998 {published data only}
    1. Engin A, Bozkurt S, Ersoy E, Oguz M, Gokcora N. Stress hyperglycemia in minimally invasive surgery. Surgical Laparoscopy & Endoscopy 1998;8(6):435‐7. - PubMed
Essen 1995 {published data only}
    1. Essen P, Thorell A, McNurlan MA, Anderson S, Ljungqvist O, Wernerman J, et al. Laparoscopic cholecystectomy does not prevent the postoperative protein catabolic response in muscle. Annals of Surgery 1995;222:36‐42. - PMC - PubMed
Frazee 1991 {published data only}
    1. Frazee RC, Roberts JW, Okeson GC, Symmonds RE, Snyder SK, Hendricks JC, et al. Open versus laparoscopic cholecystectomy. A comparison of postoperative pulmonary function. Annals of Surgery 1991;213:651‐3. - PMC - PubMed
Gal 1997 {published data only}
    1. Gal I, Roth E, Lantos J, Varga G, Jaberansari MT. Inflammatory mediators and surgical trauma regarding laparoscopic access: free radical mediated reactions. Acta Chirurgica Hungarica 1997;36:97‐9. - PubMed
Galizia 2001 {published data only}
    1. Galizia G, Prizio G, Lieto E, Castellano P, Pelosio L, Imperatore V, et al. Hemodynamic and pulmonary changes during open, carbon dioxide pneumoperitoneum, and abdominal wall‐lifting cholecystectomy ‐ A prospective, randomized study. Surgical Endoscopy 2001;15(5):477‐83. - PubMed
GarciaCaballero 1993 {published data only}
    1. Garcia‐Caballero M, Vara‐Thorbeck C. The evolution of postoperative ileus after laparoscopic cholecystectomy ‐ a comparative study with conventional cholecystectomy and sympathetic blockade treatment. Surgical Endoscopy 1993;7(5):416‐9. - PubMed
Glaser 1995 {published data only}
    1. Glaser F, Kuntz C, Klee F, Buhr HJ, Sannwald G, Herfarth C. General stress response to conventional and laparoscopic cholecystectomy. Langenbecks Archiv fur Chirurgie 1993;Suppl 1 Forumband:45‐8. - PMC - PubMed
    1. Glaser F, Sannwald GA, Buhr HJ, Kuntz C, Mayer H, Klee F, et al. General stress response to conventional and laparoscopic cholecystectomy. Annals of Surgery 1995;221(4):372‐80. - PMC - PubMed
Go 1995 {published data only}
    1. Go PMNYH, Stolk MFJ, Obertop H, Dirksen C, Elst DH, Ament A, et al. Symptomatic gallbladder stones: cost‐effectiveness of treatment with extracorporeal shock‐wave lithotripsy, conventional and laparoscopic cholecystectomy. Surgical Endoscopy 1995;9(1):37‐41. - PubMed
Hagmuller 1997 {published data only}
    1. Hagmuller E, Lorenz D, Gunther HJ, Rumstadt B, Jentschura D. Comparison of catabolic response in muscle after laparoscopic cholecystectomy or conventional chlecystectomy using a 13C‐leucine tracer model [Untersuchungen zum Ausmass der postoperativen Katabolie nach laparoskopischer und konventioneller Cholecystektomie unter Anwendung eines 13C‐leuzin‐tracermodells]. Langenbecks Archiv fur Chirurgie 1997;I Forumband:241‐5.
Hasukic 2002 {published data only}
    1. Hasukic S, Mesic D, Dizdarevic E, Keser D, Hadziselimovic S, Bazardzanovic M. Pulmonary function after laparoscopic and open cholecystectomy. Surgical Endoscopy 2002;16(1):163‐5. - PubMed
Hauer‐Jensen 1986 {published data only}
    1. Hauer‐Jensen M, Karesen R, Nygaard K, Solheim K, Amlie E, Havig O, et al. Consequences of routine peroperative cholangiography during cholecystectomy for gallstone disease: a prospective, randomized study. World Journal of Surgery 1986;10(6):996‐1002. - PubMed
Hendolin 2000 {published data only}
    1. Hendolin HI, Paakkonen ME, Alhava EM, Tarvainen R, Kemppinen T, Lahtinen P. Laparoscopic or open cholecystectomy: a prospective randomised trial to compare postoperative pain, pulmonary function, and stress response. European Journal of Surgery 2000;166(5):394‐9. - PubMed
Hobbs 1995 {published data only}
    1. Hobbs KEF. Laparoscopic cholecystectomy. Gut 1995;36(2):161‐4. - PMC - PubMed
Huang 1996 {published data only}
    1. Huang SM, Wu CW, Lui WY, Peng FK. A prospective randomised study of laparoscopic v. open cholecystectomy in aged patients with cholecystolithiasis. South African Journal of Surgery 1996;34(4):177‐9. - PubMed
Huguier 1997 {published data only}
    1. Huguier M. Laparoscopic digestive surgery. Hepato‐Gastroenterology 1997;44(13):2‐3. - PubMed
Hunter 2001 {published data only}
    1. Hunter JG. Clinical trials and the development of laparoscopic surgery. Surgical Endoscopy 2001;15(1):1‐3. - PubMed
Iwase 1992 {published data only}
    1. Iwase K, Takenaka H, Yagura A, Ishizaka T, Takagaki M, Ohata T, et al. Changes of hemodynamic parameters and urine output during laparoscopic cholecystectomy ‐ compared with mini‐laparotomy cholecystectomy: preliminary report. Nippon Geka Gakkai Zasshi 1992;93(6):663. - PubMed
Jan 1993 {published data only}
    1. Jan YY, Chen MF. Laparoscopic versus open cholecystectomy: a prospective randomized study. Journal of the Formosan Medical Association 1993;92(Suppl 4):S243‐S9. - PubMed
Johnson 1997 {published data only}
    1. Johnson A. Laparoscopic surgery. Lancet 1997;349(9052):631‐5. - PubMed
    1. Johnson A. Laparoscopic surgery ... reproduced by kind permission of the Lancet (Johnson A 1997 Laparoscopic Surgery. Lancet (349) 636‐41). British Journal of Theatre Nursing 1999;9(3):119‐24. - PubMed
Johnson 1998 {published data only}
    1. Johnson AG. New interventional procedures: efficacy, safety and training. Australian and New Zealand Journal of Surgery 1998;68(1):3‐5. - PubMed
Johnson 1998a {published data only}
    1. Johnson AG, Majeed AW. Randomized clinical trial of conventional cholecystectomy versus minicholecystectomy [letter]. British Journal of Surgery 1998;85(7):1017‐8. - PubMed
Karayiannakis 1997 {published data only}
    1. Karayiannakis AJ, Makri GG, Mantzioka A, Karousos D, Karatzas G. Postoperative pulmonary function after laparoscopic and open cholecystectomy. British Journal of Anaesthesia 1996;77(4):448‐52. - PubMed
    1. Karayiannakis AJ, Makri GG, Mantzioka A, Karousos D, Karatzas G. Systemic stress response after laparoscopic or open cholecystectomy: a randomized trial. British Journal of Surgery 1997;84(4):467‐1. - PubMed
Karayiannakis 2002 {published data only}
    1. Karayiannakis AJ, Syrigos KN, Savva A, Polychronidis A, Karatzas G, Simopoulos C. Serum E‐cadherin concentrations and their response during laparoscopic and open cholecystectomy. Surgical Endoscopy 2002;16(11):1551‐4. - PubMed
Kehlet 1993 {published data only}
    1. Kehlet H. Treatment of gallstones ‐ lithotripsy, classical, mini or laparoscopic cholecystectomy? [Behandling af galdeblaeresten ‐ litotripsi, klassisk, mini‐ eller laparoskopisk kolecystektomi?]. Ugeskrift for Laeger 1993;155(11):816‐7. - PubMed
Kiviluoto 1997 {published data only}
    1. Kiviluoto T, Siren J, Luukkonen P, Kivilaakso E. Laparoscopic vs. open cholecystectomy for acute cholecystitis. A prospective randomized study. Gastroenterology 1997;112(4):A1452.
Kjaersgaard 1994 {published data only}
    1. Kjaersgaard P, Reiertsen O, Trondsen E, Rosseland AR, Larsen S. Comparison of sequential and fixed‐sample designs in a controlled clinical trial with laparoscopic versus conventional cholecystectomy. Scandinavian Journal of Gastroenterology 1994;29(9):854‐8. - PubMed
Koprulu 1996 {published data only}
    1. Koprulu G, Esen F, Pembeci K, Denkel T. Pulmonary mechanics during laparoscopic surgery. Advances in Experimental Medicine and Biolology 1996;388:643‐6. - PubMed
Krasinski 1998 {published data only}
    1. Krasinski Z, Gabriel M, Oszkinis G, Dzieciuchowicz L, Begier‐Krasinska B. Thrombophlebitis profunda in patients after conventional and laparoscopic cholecystectomy [Trombophlebitis profunda bei Patienten nach der konventionellen und laparoskopischen Gallenblasenentfernung]. Langenbecks Archiv fur Chirurgie 1998;115(Supp lI Kongressbericht):1105‐6. - PubMed
Krawczyk 1993 {published data only}
    1. Krawczyk M, Zieniewicz K, Najnigier B, Patkowski W, Nyckowski P. Laparoscopic versus open cholecystectomy [abstract]. British Journal of Surgery 1993;80(Suppl):S46.
Kurzawinski 1992 {published data only}
    1. Kurzawinski T, Hayter B, Tate J, Davidson B, Hobbs KEF. The cost implications of laparoscopic vs open cholecystectomy [abstract]. Gut 1992;33:S64.
Lam 1996 {published data only}
    1. Lam CM, Murray FE, Cuschieri A. Increased cholecystectomy rate after the introduction of laparoscopic cholecystectomy in Scotland. Gut 1996;38(2):282‐4. - PMC - PubMed
Lausten 1999 (1) {published data only}
    1. Lausten SB, Sefi T, Marwan I, Ibrahim TM, Jensen LS, Grofte T, et al. Postoperative hepatic catabolic stress response in patients with cirrhosis and chronic hepatitis. World Journal of Surgery 2000;24(3):365‐71. - PubMed
    1. Lausten SB, Ibrahim TM, Sefi T, Jensen LS, Gesser B, Larsen CG, et al. Systemic and cell‐mediated immune response after laparoscopic and open cholecystectomy in patients with chronic liver disease ‐ A randomized, prospective study. Digestive Surgery 1999;16(6):471‐7. - PubMed
Lausten 1999 (2) {published data only}
    1. Lausten SB, Sefi T, Marwan I, Ibrahim TM, Jensen LS, Grofte T, et al. Postoperative hepatic catabolic stress response in patients with cirrhosis and chronic hepatitis. World Journal of Surgery 2000;24(3):365‐71. - PubMed
    1. Lausten SB, Ibrahim TM, Sefi T, Jensen LS, Gesser B, Larsen CG, et al. Systemic and cell‐mediated immune response after laparoscopic and open cholecystectomy in patients with chronic liver disease ‐ A randomized, prospective study. Digestive Surgery 1999;16(6):471‐7. - PubMed
Lujan 1998 {published data only}
    1. Lujan JA, Sanchez‐Bueno F, Parrilla P, Robles R, Torralba JA, Gonzalez‐Costea R. Laparoscopic vs. open cholecystectomy in patients aged 65 and older. Surgical Laparoscopy & Endoscopy 1998;8(3):208‐10. - PubMed
Lukichev 1983 {published data only}
    1. Lukichev OD, Filimonov MI, Zybin IM. A method of laparoscopic cholecystostomy [Metodika laparoskopicheskoi kholetsistostomii]. Khirurgiia 1983;8:125‐7. - PubMed
Luo 2003 {published data only}
    1. Luo K, Li J, Li L, Wang G, Sun J, Wu S. Operative stress response and energy metabolism after laparoscopic cholecystectomy and open cholecystectomy. Zhonghua Wai Ke Za Zhi [Chinese Journal of Surgery] 2002;40(12):923‐6. - PubMed
    1. Luo K, Li JS, Li LT, Wang KH, Shun JM. Operative stress response and energy metabolism after laparoscopic cholecystectomy compared to open surgery. World Journal of Gastroenterology 2003;9(4):847‐50. - PMC - PubMed
Makinen 1995 {published data only}
    1. Makinen AMH, Nordback IH. Cholecystectomy ‐ comparison of minilaparotomy and laparoscopy. International Surgery 1995;80(2):99‐101. - PubMed
Malaysian HTA 2005 {published data only}
    1. Malaysian Health Technology Assessment Unit (MHTAU). Minimal access surgery. Kuala Lumpur: Malaysian Health Technology Assessment Unit (MHTAU) 2003.
Maruszynski 1995 {published data only}
    1. Maruszynski M, Pojda Z. Interleukin 6 (IL‐6) levels in the monitoring of surgical trauma. A comparison of serum IL‐6 concentrations in patients treated by cholecystectomy via laparotomy or laparoscopy. Surgical Endoscopy 1995;9(8):882‐5. - PubMed
Matsunaga 1996 {published data only}
    1. Matsunaga MA. Postoperativepain relief and epidural analgesia for open cholecystectomy, laparoscopic cholecystectomy, and gastrectomy. Anesthesia and Resuscitation 1996;32:257‐61.
McKellar 1995 {published data only}
    1. McKellar DP, Johnson RM, Dutro JA, Mellinger JB, Peoples JB. Cost‐effectiveness of laparoscopic cholecystectomy. Surgical Endoscopy 1995;9(2):158‐63. - PubMed
McMahon 1996 {published data only}
    1. McMahon AJ, O'Dwyer PJ, Baxter JN. Randomised trial of laparoscopic versus small‐incision cholecystectomy [letter]. Lancet 1996;347(9015):1622. - PubMed
Mealy 1992 {published data only}
    1. Mealy K, Gallagher H. Comparison of the physiological responses to open and laparoscopic cholecystectomy [abstract]. Irish Journal of Medical Science 1992;161:92.
    1. Mealy K, Gallagher H, Barry M, Lennon F, Traynor O, Hyland J. Physiological and metabolic responses to open and laparoscopic cholecystectomy. British Journal of Surgery 1992;79:1061‐4. - PubMed
Milheiro 1994 {published data only}
    1. Milheiro A, Sousa FC, Manso EC, Leitao F. Metabolic responses to cholecystectomy ‐ open vs laparoscopic approach. Journal of Laparoendoscopic Surgery 1994;4(5):311‐7. - PubMed
Mimica 2000 {published data only}
    1. Mimica Z, Biocic M, Bacic A, Banovic I, Tocilj J, Radonic V, et al. Laparoscopic and laparotomic cholecystectomy: a randomized trial comparing postoperative respiratory function. Respiration 2000;67(2):153‐8. - PubMed
Mrksic 2001 {published data only}
    1. Mrksic M, Cabafi Z, Feher I, Mirkovic M. Operative trauma during laparoscopic and open cholecystectomy [Operativna trauma pri laparoskopskoj i klasicnoj holecistektomiji]. Medicinski Pregled 2001;54(7‐8):327‐31. - PubMed
Novitsky 2002 {published data only}
    1. Novitsky YW, Czerniach DR, Perugini RA, Yood SM, Kercher KW, Gallagher KA, et al. Prospective randomized trial of mini‐port vs conventional laparoscopic cholecystectomy [abstract]. Gastroenterology 2002;123(1):24.
O'Dwyer 1992 {published data only}
    1. O'Dwyer PJ, McGregor JR, McDermott EWM, Murphy JJ, O'Higgins NJ. Patient recovery following cholecystectomy through a 6‐cm or 15‐cm transverse subcostal incision ‐ a prospective randomized clinical trial. Postgraduate Medical Journal 1992;68(804):817‐9. - PMC - PubMed
Ogawa 2001 {published data only}
    1. Ogawa T, Shimizu S, Mizumoto K, Uchiyama A, Yokohata K, Chijiiwa K, et al. Comparison of laparoscopic versus open cholecystectomy in patients with cardiac valve replacement. Journal of Hepato‐Biliary‐Pancreatic Surgery 2001;8(2):158‐60. - PubMed
Olsen 1993a {published data only}
    1. Olsen DO. Mini‐lap cholecystectomy. American Journal of Surgery 1993;165(4):440‐3. - PubMed
Ortega 1996 {published data only}
    1. Ortega AE, Peters JH, Incarbone R, Estrada L, Ehsan A, Kwan Y, et al. A prospective randomized comparison of the metabolic and stress hormonal responses of laparoscopic and open cholecystectomy. Journal of the American College of Surgeons 1996;183(3):249‐56. - PubMed
Plaisier 1995 {published data only}
    1. Plaisier PW, Hul RL, Nijs HGT, Toom R, Terpstra OT, Bruining HA. Quality of life and the course of biliary and gastrointestinal symptoms after laparoscopic and conventional cholecystectomy. Digestive Surgery 1995;12:87‐91.
Prisco 2000 {published data only}
    1. Prisco D, Gaudio AR, Carla R, Gori AM, Fedi S, Cella AP, et al. Videolaparoscopic cholecystectomy induces a hemostasis activation of lower grade than does open surgery. Surgical Endoscopy 2000;14(2):170‐4. - PubMed
Putensen‐Himmer 1992 {published data only}
    1. Putensen‐Himmer G, Putensen C, Lammer H, Lingnau W, Aigner F, Benzer H. Comparison of postoperative respiratory function after laparoscopy or open laparotomy for cholecystectomy. Anesthesiology 1992;77(4):675‐80. - PubMed
Rademaker 1992 {published data only}
    1. Rademaker BM, Ringers J, Odoom JA, Wit LT, Kalkman CJ, Oosting J. Pulmonary function and stress response after laparoscopic cholecystectomy: comparison with subcostal incision and influence of thoracic epidural analgesia. Anesthesia and Analgesia 1992;75(3):381‐5. - PubMed
Rhodes 1996 {published data only}
    1. Rhodes MG, Gompertz H, Armstrong K, Lennard T, Rees B. Randomised trial of laparoscopic versus small‐incision cholecystectomy [letter]. Lancet 1996;347(9015):1621‐2. - PubMed
Romana 2000 {published data only}
    1. Romana K, Avgoustatou K, Paparizou N, Korolanoglou D, Galanaki E, Karamichali E. Neuroendocrine responses to laparoscopic and open cholecystectomy [abstract]. European Journal of Anaesthesiology 2000;17:43.
Rovina 1996 {published data only}
    1. Rovina N, Bouros D, Tzanakis N, Velegrakis M, Kandilakis S, Vlasserou F, et al. Effects of laparoscopic cholecystectomy on global respiratory muscle strength. American Journal of Respiratory and Critical Care Medicine 1996;153(1):458‐61. - PubMed
Schauer 1993 {published data only}
    1. Schauer PR, Luna J, Ghiatas AA, Glen ME, Warren JM, Sirinek KR. Pulmonary function after laparoscopic cholecystectomy. Surgery 1993;114(2):389‐97. - PubMed
Schauer 1995 {published data only}
    1. Schauer PR, Sirinek KR. The laparoscopic approach reduces the endocrine response to elective cholecystectomy. American Surgeon 1995;61(2):106‐11. - PubMed
Schaupp 1988 {published data only}
    1. Schaupp W, Menges HW, Schworm HD. The ideal cholecystectomy ‐ a prospective randomized study [Die 'ideale' Cholecystektomie ‐ eine prospektive, randomisierte Studie]. Chirurg 1988;59(10):661‐4. - PubMed
    1. Schaupp W, Menges HW, Trede M. The 'ideal' cholecystectomy: a prospective randomized study. Langenbecks Archiv fur Chirurgie 1987;372(Kongressbericht):839. - PubMed
Schmitz 1997 {published data only}
    1. Schmitz R, Rohde V, Treckmann J, Shah S. Randomized clinical trial of conventional cholecystectomy versus minicholecystectomy. British Journal of Surgery 1997;84(12):1683‐6. - PubMed
Seenu 1994 {published data only}
    1. Seenu V, Misra MC. Mini‐lap cholecystectomy ‐ an attractive alternative to conventional cholecystectomy. Tropical Gatroenterology 1994;15(1):29‐31. - PubMed
Thaler 1995 {published data only}
    1. Thaler W, Frey L, Messmer K, Marzoli GP. Assessment of splanchnic blood flow by gastric tonometry in patients undergoing laparoscopic and open cholecystectomy. Langenbecks Archiv fur Chirurgie 1995;Suppl 1 Forumband:23‐6.
Toouli 1998 {published data only}
    1. Toouli J, Wright TA. Gastroenterology ‐ 5. Gallstones. Medical Journal of Australia 1998;169(3):166‐71. - PubMed
Trondsen 1993 {published data only}
    1. Trondsen E, Reiertsen O, Andersen OK, Kjaersgaard P. Laparoscopic and open cholecystectomy ‐ a prospective, randomized study. European Journal of Surgery 1993;159(4):217‐21. - PubMed
Ueo 1994 {published data only}
    1. Ueo H, Honda M, Adachi M, Inoue H, Nakashima H, Arinaga S, et al. Minimal increase in serum interleukin‐6 levels during laparoscopic cholecystectomy. American Journal of Surgery 1994;168:358‐60. - PubMed
Volpino 1998 {published data only}
    1. Volpino P, Cangemi V, D'Andrea N, Cangemi B, Piat G. Hemodynamic and pulmonary changes during and after laparoscopic cholecystectomy. A comparison with traditional surgery. Surgical Endoscopy 1998;12(2):119‐23. - PubMed
Wani 2002 {published data only}
    1. Wani KA, Dar HA, Malik AA, Chowdry NA. Comparison of postoperative pulmonary function tests after cholecystectomy performed through Kocher's incision and mini‐incision. International Surgery 2002;87(2):94‐8. - PubMed
    1. Wani KA, Malik AA, Noor UD, Wani NA, Chowdhry N. Minicholecystectomy vs conventional cholecystectomy: a prospective study. Implications in the laparoscopic era. JK Practitioner 2000;7:30‐3.
Williams 1993 {published data only}
    1. Williams MD, Sulentich SM, Murr PC. Laparoscopic cholecystectomy produces less postoperative restriction of pulmonary function than open cholecystectomy. Surgical Endoscopy 1993;7(6):489‐92. - PubMed
Yerdel 1997 {published data only}
    1. Yerdel MA, Koksoy C, Aras N, Orita K. Laparoscopic versus open cholecystectomy in cirrhotic patients: a prospective study. Surgical Laparoscopy & Endoscopy 1997;7(6):483‐6. - PubMed
Zajac 1998 {published data only}
    1. Zajac M, Zajac K, Engel Z. Laparoscopy vs laparotomy for cholecystectomy in elderly patients [abstract]. British Journal of Anaesthesia 1998;80(Suppl 1):2.
Zulfikaroglu 2002 {published data only}
    1. Zulfikaroglu B, Koc M, Soran A, Isman FK, Cinel I. Evaluation of oxidative stress in laparoscopic cholecystectomy. Surgery Today 2002;32(10):869‐74. - PubMed

Additional references

Assalia 1993a
    1. Assalia A, Schein M, Kopelman D, Hashmonai M. Minicholecystectomy vs conventional cholecystectomy: a prospective randomized trial: implications in the laparoscopic era. World Journal of Surgery 1993;17:755‐9. - PubMed
Assalia 1997
    1. Assalia A, Kopelman D, Hashmonai M. Emergency minilaparotomy cholecystectomy for acute cholecystitis: prospective randomized trial: implications for the laparoscopic era. World Journal of Surgery 1997;21(5):534‐9. - PubMed
Assmann 2000
    1. Assmann SF, Pocock SJ, Enos LE, Kasten LE. Subgroup analysis and other (mis)uses of baseline data in clinical trials. Lancet 2000;355:1064‐9. - PubMed
Begg 1994
    1. Begg CB, Mazumdar M. Operating characteristics of a rank correlation test for publication bias. Biometrics 1994;50(4):1088‐101. - PubMed
DeMets 1987
    1. DeMets DL. Methods of combining randomized clinical trials: strengths and limitations. Statistics in Medicine 1987;6(3):341‐50. - PubMed
DerSimonian 1986
    1. DerSimonian R, Laird N. Meta‐analysis in clinical trials. Controlled Clinical Trials 1986;7(3):177‐88. - PubMed
Deveney 1993
    1. Deveney KE. The early experience with laparoscopic cholecystectomy in Oregon. Archives of Surgery 1993;128(6):627‐32. - PubMed
Deziel 1993
    1. Deziel DJ, Millikan KW, Economou SG, Doolas A, Ko ST, Airan MC. Complications of laparoscopic cholecystectomy: a national survey of 4292 hospitals and an analysis of 77604 cases. American Journal of Surgery 1993;165(1):9‐14. - PubMed
Deziel 1994
    1. Deziel DJ. Complications of cholecystectomy. Incidence, clinical manifestations, and diagnosis. Surgical Clinics of North America 1994;74(4):809‐23. - PubMed
Downs 1996
    1. Downs SH, Black NA, Devlin HB, Royston CM, Russell RC. Systematic review of the effectiveness and safety of laparoscopic cholecystectomy. Annals of the Royal College of Surgeons of England 1996;78(3 part II):241‐323. - PMC - PubMed
Dubois 1982
    1. Dubois F, Berthelot B. [Cholecystectomy through minimal incision (author's translation)]. Nouvelle Presse Medicale 1982;11(15):1139‐41. - PubMed
Egger 1997
    1. Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta‐analysis detected by a simple graphical test. BMJ (Clinical Research Ed.) 1997;315(7109):629‐34. - PMC - PubMed
Egger 2003
    1. Egger M, Davey SG, Schneider M, Binder C. Bias in meta‐analysis detected by a simple, graphical test. Health Technology Assessment 2003;7(1):1‐76.
Goco 1983
    1. Goco IR, Chambers LG. "Mini‐cholecystectomy" and operative cholangiography. A means of cost containment. American Surgeon 1983;49(3):143‐5. - PubMed
Higgins 2002
    1. Higgins JPT, Thompson SG. Quantifying heterogeneity in a meta‐analysis. Statistics in Medicine 2002;21:1539‐58. - PubMed
Higgins 2005
    1. Higgins JPT, Green S, editors. Cochrane Handbook for Systematic Reviews of Interventions 4.2.5 [updated May 2005]. The Cochrane Library, Issue 3, 2005. Chichester, UK: John Wiley & Sons, Ltd.
Jüni 2001
    1. Jüni P, Altman DG, Egger M. Systematic reviews in health care: assessing the quality of controlled clinical trials. BMJ (Clinical Research Ed.) 2001;323(7303):42‐6. - PMC - PubMed
Keus 2004
    1. Keus, HG Gooszen, I van der Tweel, CJHM van Laarhoven. Laparoscopic, small‐incision, or open cholecystectomy for patients with symptomatic cholecystolithiasis. The Cochrane Database of Systematic Reviews 2004, Issue 2. Art. No.: CD004788. DOI: 10.1002/14651858.CD004788. - PMC - PubMed
Kjaergard 2001
    1. Kjaergard LL, Villumsen J, Gluud C. Reported methodological quality and discrepancies between large and small randomised trials in meta‐analyses. Annals of Internal Medicine 2001;135(11):982‐9. [MEDLINE: ] - PubMed
Ledet 1990
    1. Ledet WP Jr. Ambulatory cholecystectomy without disability. Archives of Surgery 1990;125(11):1434‐5. - PubMed
Legorreta 1993
    1. Legorreta AP, Silber JH, Costantino GN, Kobylinski RW, Zatz SL. Increased cholecystectomy rate after the introduction of laparoscopic cholecystectomy. Journal of the American Medical Association 1993;270(12):1429‐32. - PubMed
Litwin 1992
    1. Litwin DE, Girotti MJ, Poulin EC, Mamazza J, Nagy AG. Laparoscopic cholecystectomy: trans‐Canada experience with 2201 cases. Canadian Journal of Surgery 1992;35(3):291‐6. - PubMed
Macaskill 2001
    1. Macaskill P, Walter SD, Irwig L. A comparison of methods to detect publication bias in meta‐analysis. Statistics in Medicine 2001;20:641‐54. - PubMed
Merrill 1988
    1. Merrill JR. Minimal trauma cholecystectomy (a 'no‐touch' procedure in a 'well'). American Surgeon 1988;54(5):256‐61. - PubMed
Moher 1998
    1. Moher D, Pham B, Jones A, Cook DJ, Jadad AR, Moher M, et al. Does quality of reports of randomised trials affect estimates of intervention efficacy reported in meta‐analyses. Lancet 1998;352(9128):609‐13. [MEDLINE: ] - PubMed
Moss 1986
    1. Moss G. Discharge within 24 hours of elective cholecystectomy. Archives of Surgery 1986;121:1159‐61. [MEDLINE: ] - PubMed
Mühe 1986
    1. Mühe E. The first cholecystectomy through the laparoscope [Die erste Cholecystektomie durch das Laparoskop]. Langenbecks Archiv für Chirurgie 1986;369:804.
NIH Consensus 1993
    1. NIH Consensus Development Panel on Gallstones and Laparoscopic Cholecystectomy. Journal of the American Medical Association 1993;269(8):1018‐24. [MEDLINE: ] - PubMed
O'Dwyer 1990
    1. O'Dwyer PJ, Murphy JJ, O'Higgins NJ. Cholecystectomy through a 5 cm subcostal incision. British Journal of Surgery 1990;77(10):1189‐90. - PubMed
O'Dwyer 1992
    1. O'Dwyer PJ, McGregor JR, McDermott EW, Murphy JJ, O'Higgins NJ. Patient recovery following cholecystectomy through a 6 cm or 15 cm transverse subcostal incision: a prospective randomized clinical trial. Postgraduate Medical Journal 1992;68(804):817‐9. - PMC - PubMed
Olsen 1991
    1. Olsen DO. Laparoscopic cholecystectomy. American Journal of Surgery 1991;161:339‐44. [MEDLINE: ] - PubMed
Olsen 1993
    1. Olsen DO. Mini‐lap cholecystectomy. American Journal of Surgery 1993;165(4):440‐3. - PubMed
RevMan 2003 [Computer program]
    1. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration. Review Manager (RevMan). Version 4.2 for Windows. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2003.
Roslyn 1993
    1. Roslyn JJ, Binns GS, Hughes EFX, Saunders‐Kirkwood K, Zinner MJ, Cates JA. Open cholecystectomy. A contemporary analysis of 42474 patients. Annals of Surgery 1993;218(2):129‐37. - PMC - PubMed
Schmitz 1997
    1. Schmitz R, Rohde V, Treckman J, Shah S. Randomized trial of conventional cholecystectomy versus minicholecystectomy. British Journal of Surgery 1997;84(12):1683‐6. - PubMed
Schulz 1995
    1. Schulz KF, Chalmers I, Hayer R, Altman D. Empirical evidence of bias. Journal of the American Medical Association 1995;273(5):408‐12. [MEDLINE: ] - PubMed
Seale 1999
    1. Seale AK, Ledet WP Jr. Minicholecystectomy: a safe, cost‐effective day surgery procedure. Archives of Surgery 1999;134(3):308‐10. - PubMed
Southern Surg 1991
    1. Southern Surgeons' Club. A prospective analysis of 1518 laparoscopic cholecystectomies. New England Journal of Medicine 1991;324(16):1073‐8. - PubMed
Steiner 1994
    1. Steiner CA, Bass EB, Talamini MA, Pitt HA, Steinberg EP. Surgical rates and operative mortality for open and laparoscopic cholecystectomy in Maryland. New England Journal of Medicine 1994;330(6):403‐8. - PubMed
Sweeting 2004
    1. Sweeting MJ, Sutton AJ, Lambert PC. What to add to nothing? Use and avoidance of continuity corrections in meta‐analysis of sparse data. Statistics in Medicine 2004;23:1351‐75. - PubMed
Tyagi 1994
    1. Tyagi NS, Meredith MC, Lumb JC, Cacdac RG, Vanterpool CC, Rayls KR, et al. A new minimally invasive technique for cholecystectomy. Subxiphoid "minimal stress triangle": microceliotomy. Annals of Surgery 1994;220(5):617‐25. - PMC - PubMed
Vist 2004
    1. Vist GE, Hagen KB, Devereaux PJ, Bryant D, Kristoffersen DT, Oxman AD. Outcomes of patients who participate in randomised controlled trials compared to similar patients receiving similar interventions who do not participate. Cochrane Database of Methodology Reviews 2004, Issue 4. Art. No.: MR000009. DOI: 10.1002/14651858.MR000009.pub2. - PubMed
Vitale 1991
    1. Vitale GC, Collet D, Larson GM, Cheadle WG, Miller FB, Perissat J. Interruption of professional and home activity after laparoscopic cholecystectomy among French and American patients. American Journal of Surgery 1991;161(3):396‐8. - PubMed
Wherry 1994
    1. Wherry DC, Rob CG, Marohn MR, Rich NM. An external audit of laparoscopic cholecystectomy performed in medical treatment facilities of the department of Defense. Annals of Surgery 1994;220(5):626‐34. - PMC - PubMed

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