Open versus laparoscopic surgery in the management of patients with gallbladder cancer: A systematic review and meta-analysis

Abstract

Background: The aim of this meta-analysis was to assess the safety and efficacy of laparoscopic surgery when compared to open surgery in the management of gallbladder cancer.

Methods: Ovid Cochrane Library, Medline, Embase, Epub, and Scopus were searched. A meta-analysis of selected studies was performed, and a subgroup analysis was performed by tumor stage.

Results: Fourteen studies met the eligibility criteria with a total of 1792 participants undergoing either laparoscopic or open surgery. Survival rate of laparoscopic group was higher than open group at T2 tumor stage after 1 year (OR = 2.130, 95%CI: 1.372, 3.306, I² = 0%) and 2 year (OR = 2.074, 95%CI: 1.411, 3.050, I² = 0%) as well as T3 tumor stage after 1 year (OR = 2.805, 95%CI: 1.631, 4.826, I² = 0%) and 2 year (OR = 2.453, 95%CI: 1.367, 4.400, I² = 0%). Additionally, overall recurrence rate between laparoscopic and open cohorts was similar (OR: 1.098, 95%CI: 0.774, 1.558, I² = 5.56%).

Conclusion: In comparison to open surgery, the results seem to show a trend favoring laparoscopic surgery as a possible alternative treatment option to commence the management of gallbladder cancer.

Keywords: Cholecystectomy; Gallbladder cancer; Laparoscopic; Meta-analysis; Open.