| Gallbladder cancer is the most common malignant tumor in the biliary tract system,accounting for about 46%.It has a high degree of malignancy,insensitivity to radiotherapy and chemotherapy,and a short survival period,with a 5-year survival rate of less than 5%[1],and its incidence increases every year[2-3].Ever since the onset of the disease conceals,early symptoms not obvious,so many for middle-late patients clinically,and middle-late gallbladder surgery effect is poorer and less postoperative quality of life,so early diagnosis and treatment for patients with gallbladder is essential,at the same time,with the development of medical diagnostic equipment and improvement of the diagnosis of gallbladder increasingly early[4].Radical open resection of gallbladder carcinoma has been performed for many years,and its clinical effects have been recognized by surgical experts.However,in recent years,with the extensive application and development of laparoscopic technology in gastrointestinal tumor surgery,more and more hepatobiliary surgeons have begun to carry out complete laparoscopic radical resection of gallbladder carcinoma for early gallbladder cancer（T2 stage and below）[5-6].But there is also a lot of opposition to the procedure.In this paper,a meta-analysis was conducted to compare the two treatment methods for early gallbladder cancer by integrating multiple clinical outcome indicators,providing a strong basis for clinical work.Objective:To compare the clinical efficacy of laparoscopic and open radical resection for early gallbladder carcinomaMethods:A computerized search of English and Chinese databases for comparative studies of laparoscopic versus open surgery in the treatment of early gallbladder cancer（up to September 2020）.After quality assessment and data extraction of the included literatures,Rev Man 5.3 software was used for statistical analysis of the data.Results:A total of 8 non-randomized controlled trials with 462 patients（LRC214,ORC248）were included in this study.The results showed that in the LRC group,the intraoperative blood loss was lower（WMD=-113.44,95%CI=-163.58～-63.30,P<0.00001）,the incidence of complications was low（OR=0.51,95%CI=0.27-0.96,P=0.04）,and the length of postoperative hospital stay was shortened（WMD=-5.03,95%CI=-6.61-3.46,P<0.00001）,the local recurrence rate was low（OR=0.42,95%CI=0.20-0.87,P=0.02）,but the operative time（WMD=-22.39,95%CI=-52.02～7.24,P=0.14）and the number of lymph nodes dissection（WMD=-0.86,95%CI=-2.34-0.62,P=0.25）were not significantly different from ORC group.Conclusions:Based on the included studies,the advantages of LRC are mainly reflected in less intraoperative injury,less blood loss,effectively shortening the length of hospital stay of patients,and reducing the incidence of postoperative complications and postoperative local recurrence.LRC is basically the same as ORC in terms of the number of lymph nodes acquired and operation time.Therefore,LRC in the treatment of early gallbladder cancer is worthy of further promotion in clinical work.However,this conclusion still needs to be verified by more high-quality studies. |
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