| Objective: To evaluate the effectiveness, safety and cost of laparoscope cholecystectomy and tradition open cholecystectomy. Methods: We searched MEDLINE, OVID, The Cochrane Central Register of Controlled Trials and CBMdisc. Eight journals and the references of eligible studies were hand searched. To extract the data messages after evaluated the quality of internalized studies. RevMan4.2.2 software was used for meta-analysis. According to the result of Heterogeneity test we decided which model would be used, fixed effects model or random effects model. Sensitivity analysis and publication bias evaluation were carried out. Results: Ten RCTs including a total of 988 patients met the inclusion criteria for the meta-analysis. Only a RCT quality is the A grade in 10 pieces of literature, 3 pieces of literature are the B grade, other 6 are C grade.Complication rate of laparoscope cholecystectomy was lower than open cholecystectomy,P=0.0009, RR=0.50, 95%CI 为(0.33,0.75)..Tows of the indexes of postoperative pulmonary function have statistical significance. Other indexes all have no statistical significance. There was no statistical significance between LC and OC on mean operating time, P=0.10, 95%CI 为(-0.23, 27.89). Postoperative hospital stays, and patient sick leave time was significantly shorter in the LC than the OC group(P=0.004and P=0.03). Total hospital cost was not significantly in the LC and the OC group. Sensitivity analysis suggested that the results have a good reliability. No significant publication bias has been found. Conclusions: Evidences indicated that laparoscope cholecystectomy was superior to open cholecystectomy in many aspects. But we need to include in more high quality studies with compact designs and scientific method, in order to strengthen the argument.
|
PDF Full Text Request