Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2015 May 7;21(17):5393-406.
doi: 10.3748/wjg.v21.i17.5393.

Transvaginal cholecystectomy vs conventional laparoscopic cholecystectomy for gallbladder disease: A meta-analysis

Bin Xu  1 , Bo Xu  1 , Wen-Yan Zheng  1 , Hai-Yan Ge  1 , Li-Wei Wang  1 , Zhen-Sun Song  1 , Bin He  1
Affiliations
Review

Transvaginal cholecystectomy vs conventional laparoscopic cholecystectomy for gallbladder disease: A meta-analysis

Bin Xu et al. World J Gastroenterol. .

Abstract

Aim: To compare the results of transvaginal cholecystectomy (TVC) and conventional laparoscopic cholecystectomy (CLC) for gallbladder disease.

Methods: We performed a literature search of PubMed, EMBASE, Ovid, Web of Science, Cochrane Library, Google Scholar, MetaRegister of Controlled Trials, Chinese Medical Journal database and Wanfang Data for trials comparing outcomes between TVC and CLC. Data were extracted by two authors. Mean difference (MD), standardized mean difference (SMD), odds ratios and risk rate with 95%CIs were calculated using fixed- or random-effects models. Statistical heterogeneity was evaluated with the χ(2) test. The fixed-effects model was used in the absence of statistically significant heterogeneity. The random-effects model was chosen when heterogeneity was found.

Results: There were 730 patients in nine controlled clinical trials. No significant difference was found regarding demographic characteristics (P > 0.5), including anesthetic risk score, age, body mass index, and abdominal surgical history between the TVC and CLC groups. Both groups had similar mortality, morbidity, and return to work after surgery. Patients in the TVC group had a lower pain score on postoperative day 1 (SMD: -0.957, 95%CI: -1.488 to -0.426, P < 0.001), needed less postoperative analgesic medication (SMD: -0.574, 95%CI: -0.807 to -0.341, P < 0.001) and stayed for a shorter time in hospital (MD: -1.004 d, 95%CI: -1.779 to 0.228, P = 0.011), but had longer operative time (MD: 17.307 min, 95%CI: 6.789 to 27.826, P = 0.001). TVC had no significant influence on postoperative sexual function and quality of life. Better cosmetic results and satisfaction were achieved in the TVC group.

Conclusion: TVC is safe and effective for gallbladder disease. However, vaginal injury might occur, and further trials are needed to compare TVC with CLC.

Keywords: Conventional laparoscopic cholecystectomy; Endoscopic surgery; Meta-analyses; Natural orifice; Transvaginal cholecystectomy.

PubMed Disclaimer

Figures

Figure 1
Figure 1
The flowchart for systematic review.
Figure 2
Figure 2
Demographic characteristics between transvaginal cholecystectomy and conventional laparoscopic cholecystectomy. TVC: Transvaginal cholecystectomy; CLC: Conventional laparoscopic cholecystectomy.
Figure 3
Figure 3
Meta-analysis for overall postoperative complications. Transvaginal cholecystectomy vs conventional laparoscopic cholecystectomy.
Figure 4
Figure 4
Conversion rate during transvaginal cholecystectomy. TVC: Transvaginal cholecystectomy; CLC: Conventional laparoscopic cholecystectomy.
Figure 5
Figure 5
Meta-analysis for operative time between transvaginal cholecystectomy and conventional laparoscopic cholecystectomy. TVC: Transvaginal cholecystectomy; CLC: Conventional laparoscopic cholecystectomy.
Figure 6
Figure 6
Negligible vaginal bleeding rate post-transvaginal cholecystectomy. TVC: Transvaginal cholecystectomy.
Figure 7
Figure 7
The rate of using an additional trocar during transvaginal cholecystectomy. TVC: Transvaginal cholecystectomy.
Figure 8
Figure 8
Meta-analysis for pain score and postoperative consumption of analgesics. Transvaginal cholecystectomy vs conventional laparoscopic cholecystectomy. TVC: Transvaginal cholecystectomy; CLC: Conventional laparoscopic cholecystectomy.
Figure 9
Figure 9
Meta-analysis for postoperative hospital stay. Transvaginal cholecystectomy vs conventional laparoscopic cholecystectomy. TVC: Transvaginal cholecystectomy; CLC: Conventional laparoscopic cholecystectomy.
Figure 10
Figure 10
Meta-analysis for return to work. Transvaginal cholecystectomy vs conventional laparoscopic cholecystectomy. TVC: Transvaginal cholecystectomy; CLC: Conventional laparoscopic cholecystectomy.
Figure 11
Figure 11
Predictive postoperative dyspareunia rate after transvaginal cholecystectomy. TVC: Transvaginal cholecystectomy.
Figure 12
Figure 12
Funnel plot based on the incidence of postoperative morbidity.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Bazzi WM, Stroup SP, Cohen SA, Sisul DM, Liss MA, Masterson JH, Kopp RP, Gudeman SR, Leeflang E, Palazzi KL, et al. Comparison of transrectal and transvaginal hybrid natural orifice transluminal endoscopic surgery partial nephrectomy in the porcine model. Urology. 2013;82:84–89. - PubMed
    1. Vieira JP, Linhares MM, Caetano EM, Moura RM, Asseituno V, Fuzyi R, Girão MJ, Ruano JM, Goldenberg A, de Jesus L Filho G, et al. Evaluation of the clinical and inflammatory responses in exclusively NOTES transvaginal cholecystectomy versus laparoscopic routes: an experimental study in swine. Surg Endosc. 2012;26:3232–3244. - PubMed
    1. Liu BR, Kong LJ, Song JT, Liu W, Yu H, Dou QF. Feasibility and safety of functional cholecystectomy by pure NOTES: a pilot animal study. J Laparoendosc Adv Surg Tech A. 2012;22:740–745. - PubMed
    1. Córdova H, Guarner-Argente C, Martínez-Pallí G, Navarro R, Rodríguez-D’Jesús A, Rodríguez de Miguel C, Beltrán M, Martínez-Zamora MÀ, Comas J, Lacy AM, et al. Gastric emptying is delayed in transgastric NOTES: a randomized study in swine. J Surg Res. 2012;174:e61–e67. - PubMed
    1. Bernhardt J, Köhler P, Rieber F, Diederich M, Schneider-Koriath S, Steffen H, Ludwig K, Lamadé W. Pure NOTES sigmoid resection in an animal survival model. Endoscopy. 2012;44:265–269. - PubMed