Work

Laparoscopic hepatectomy provides better outcomes for hepatolithiasis as compared to its open counterpart: a meta-analysis of randomized controlled trials and propensity-score-matched studies

Year: 2026

Type: review

Study designs: Systematic Review, Meta-Analysis

Abstract: BACKGROUND: Laparoscopic hepatectomy (LH) is used more commonly for hepatolithiasis, but high-level evidence is still scarce. This meta-analysis aimed to compare the short-term outcomes between LH and open hepatectomy (OH) for hepatolithiasis using data collected from randomized controlled trials (RCTs) and propensity score-matched (PSM) studies. MATERIALS AND METHODS: We searched the EMBASE, Web of Science, Scopus, PubMed, and Cochrane Library databases for RCTs and PSM studies comparing LH and OH. Risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs) were calculated. RESULTS: Ten studies encompassing 2 RCTs and 8 PSM studies were included, with a total of 1898 patients (LH group: 936 patients; OH group: 962 patients). Compared with OH, LH was associated with a lower overall morbidity (RR, 0.59), major complications (RR, 0.57), wound infection (RR, 0.27), intestinal obstruction (RR, 0.43), stone recurrence (RR, 0.49) and blood transfusion rates (RR, 0.74), less blood loss (MD, -65.97 mL), shorter length of stay (MD, -3.22 days), time to first flatus (MD, -0.76 days), time to oral intake (MD, -1.21 days), and time to ambulation (MD, -0.90 days). No significant differences were observed between LH and OH in initial stone clearance (RR, 1.03), final stone clearance (RR, 1.00), mortality (RR, 1.63), or operative time (MD, 16.90 min). CONCLUSIONS: Although LH and OH had similar surgical outcomes, LH had the perioperative advantage over OH in decreasing overall morbidity, major complications, wound infection, intestinal obstruction, stone recurrence, blood transfusion rates, blood loss, length of stay, time to first flatus, time to oral intake, and time to ambulation. Further RCTs evaluating the potential advantages of LH over OH are warranted.

Source: International Journal of Surgery

DOI: 10.1097/js9.0000000000004919

Authors: Gang Tang, Jie Zhang, Ting Jiang, Fang Chen, Rongxing Zhou

Institutions: Sichuan University, West China Hospital of Sichuan University, West China Medical Center of Sichuan University

Language: English

Topic: Gallbladder and Bile Duct Disorders

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $3,450