Laparoscopic Cholecystectomy (LC) Vs. Open Cholecystectomy (OC) For Cirrhotic Patient With Cholecystolithiasis: A Meta-analysis

Objective The aim of this meta-analysis was to compare clinical outcome followingLC and OC for the treatment of the liver cirrhosis patient with gall-stone disease.Methods The meta-analysis was made according to the PRISMA statement. Articlescomparing outcomes of LC versus OC for cirrhosis patients with cholecystolithiasispublished between January1990and December2013。Randomized controlled trials(RCTs) and non-randomized concurrent trials (NRCTs) were searched. The RevMan5.2software were used to do the analysis. Risk ratios (RR) or weighted meandifferences (WMD) with95%confidence intervals (95%CI) were calculated.Results In total,6randomized clinical trials (RCTs) and4non-randomizedcontrolled trials (NRCTs) studies were included and reported on737subjects, ofwhom377underwent LC, and360underwent OC for gall-stone disease. Nopostoperative deaths were reported in both two groups. Meta-analysis showed that LCwas associated with less operation time (WMD-24.19[-46.02,-2.35]，P=0.03), lessintra-operative blood loss (WMD-138.51[-253.14,-23.88]， P=0.02), quickerresumption of a normal diet (WMD-27.61[-30.49,-24.73]，P＜0.00001), and shorterhospital stay (WMD-3.40[-4.16,-2.65]，P=0.004). and less intra-or post-operativetransfusion (RR0.18[0.08,0.45]，P=0.0002),There was significant difference in therates of total postoperative complications (RR0.46[0.32,0.67], P <0.0001),Ⅰ～Ⅱgrade postoperative complications (RR0.37[0.26,0.53]，P <0.00001), postoperativeinfections (RR0.34[0.20,0.57], P <0.0001) and Ⅲ～Ⅳ grade postoperativecomplications (RR0.46[0.21,0.98]，P=0.04) between the two groups.Conclusions The results of this meta-analysis demonstrate that LC is a safeprocedure for the treatment for cirrhosis patients with gallstones, with safer operationprocess, better postoperative recovery and complication outcomes to that of OC.