Single-incision laparoscopic cholecystectomy versus conventional laparoscopic cholecystectomy: meta-analysis and systematic review of randomized controlled trials
Sajid, M.S.; Ladwa, N.; Kalra, L.; Hutson, K.K.; Singh, K.K.; Sayegh, M.
World Journal of Surgery 36(11): 2644-2653
ISSN/ISBN: 0364-2313 PMID: 22855214 DOI: 10.1007/s00268-012-1719-5
The objective of this study was to analyze systematically the randomized, controlled trials that compared single-incision laparoscopic cholecystectomy (SILC) and conventional laparoscopic cholecystectomy (CLC). The meta-analysis was conducted according to the Quality of Reporting of Meta-analysis (QUORUM) standards. The included studies were analyzed systematically using the statistical software package RevMan. The summated outcomes were expressed as the risk ratios (RR) for dichotomous variables and standardized mean differences (SMD) for continuous variables. Eleven randomized trials encompassing 858 patients were retrieved from the electronic databases. In the random effects model, postoperative pain, postoperative complications, length of hospital stay, cosmesis score, conversion rate, and time to return to normal activities were statistically comparable between the two cholecystectomy techniques. SILC was associated with a longer operating time [SMD 0.71; 95 % confidence interval (CI) 0.38, 1.05; z = 4.18; p < 0.0001) and an increased requirement for additional port insertion (RR 6.54; 95 % CI 2.19, 19.57; z = 3.36; p < 0008). However, there was significant heterogeneity among the trials. SILC does not offer any advantage over CLC for treating benign gallbladder disorders. CLC may be used assiduously for this purpose.