Laparoscopic versus small‐incision cholecystectomy for patients with symptomatic cholecystolithiasis

Frederik Keus; Jeroen de Jong; Hein G Gooszen; CHJM van Laarhoven

doi:10.1002/14651858.CD006229

Scolaris Content Display Scolaris Content Display

Contenido relacionado

Ir a:

Revisiones y protocolos relacionados
Guías
Temas

Revisiones y protocolos relacionados

Topics

Temas

Figure 1

Methodological quality graph: review authors' judgements about each methodological quality item presented as percentages across all included studies.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Figure 2

Methodological quality summary: review authors' judgements about each methodological quality item for each included study.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Figure 3

Funnel plot on laparoscopic versus small‐incision cholecystectomy regarding generation of the allocation sequence considering total complications, including 95% confidence interval lines. There is some suspicion of bias considering the absence (in the lower right part of the figure) of small trials favoring the small‐incision technique.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Figure 4

Funnel plot on laparoscopic versus small‐incision cholecystectomy regarding generation of the allocation sequence considering conversions, including 95% confidence interval lines. No arguments for bias.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Figure 5

Funnel plot on laparoscopic versus small‐incision cholecystectomy regarding generation of the allocation sequence considering operative time, including 95% confidence interval lines. No arguments for bias.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Figure 6

Funnel plot on laparoscopic versus small‐incision cholecystectomy regarding generation of the allocation sequence considering hospital stay, including 95% confidence interval lines. No arguments for bias.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.1

Comparison 1 LC versus SIC ‐ high‐quality and low‐quality trials regarding generation of the allocation sequence, Outcome 1 Mortality.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.2

Comparison 1 LC versus SIC ‐ high‐quality and low‐quality trials regarding generation of the allocation sequence, Outcome 2 Intra‐operative complications.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.3

Comparison 1 LC versus SIC ‐ high‐quality and low‐quality trials regarding generation of the allocation sequence, Outcome 3 Minor complications.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.4

Comparison 1 LC versus SIC ‐ high‐quality and low‐quality trials regarding generation of the allocation sequence, Outcome 4 Severe complications (without bile duct injuries).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.5

Comparison 1 LC versus SIC ‐ high‐quality and low‐quality trials regarding generation of the allocation sequence, Outcome 5 Bile duct injuries.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.6

Comparison 1 LC versus SIC ‐ high‐quality and low‐quality trials regarding generation of the allocation sequence, Outcome 6 Total complications.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.7

Comparison 1 LC versus SIC ‐ high‐quality and low‐quality trials regarding generation of the allocation sequence, Outcome 7 Conversions.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.8

Comparison 1 LC versus SIC ‐ high‐quality and low‐quality trials regarding generation of the allocation sequence, Outcome 8 Operative time (minutes).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.9

Comparison 1 LC versus SIC ‐ high‐quality and low‐quality trials regarding generation of the allocation sequence, Outcome 9 Hospital stay (days).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.10

Comparison 1 LC versus SIC ‐ high‐quality and low‐quality trials regarding generation of the allocation sequence, Outcome 10 Convalescence: work leave (days).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.11

Comparison 1 LC versus SIC ‐ high‐quality and low‐quality trials regarding generation of the allocation sequence, Outcome 11 Convalescence: normal activity (at home) (days).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.1

Comparison 2 LC versus SIC ‐ high‐quality and low‐quality trials regarding allocation concealment, Outcome 1 Mortality.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.2

Comparison 2 LC versus SIC ‐ high‐quality and low‐quality trials regarding allocation concealment, Outcome 2 Intra‐operative complications.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.3

Comparison 2 LC versus SIC ‐ high‐quality and low‐quality trials regarding allocation concealment, Outcome 3 Minor complications.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.4

Comparison 2 LC versus SIC ‐ high‐quality and low‐quality trials regarding allocation concealment, Outcome 4 Severe complications (without bile duct injuries).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.5

Comparison 2 LC versus SIC ‐ high‐quality and low‐quality trials regarding allocation concealment, Outcome 5 Bile duct injuries.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.6

Comparison 2 LC versus SIC ‐ high‐quality and low‐quality trials regarding allocation concealment, Outcome 6 Total complications.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.7

Comparison 2 LC versus SIC ‐ high‐quality and low‐quality trials regarding allocation concealment, Outcome 7 Conversions.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.8

Comparison 2 LC versus SIC ‐ high‐quality and low‐quality trials regarding allocation concealment, Outcome 8 Operative time (minutes).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.9

Comparison 2 LC versus SIC ‐ high‐quality and low‐quality trials regarding allocation concealment, Outcome 9 Hospital stay (days).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.10

Comparison 2 LC versus SIC ‐ high‐quality and low‐quality trials regarding allocation concealment, Outcome 10 Convalescence: work leave (days).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.11

Comparison 2 LC versus SIC ‐ high‐quality and low‐quality trials regarding allocation concealment, Outcome 11 Convalescence: normal activity (at home) (days).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.1

Comparison 3 LC versus SIC ‐ high‐quality and low‐quality trials regarding blinding, Outcome 1 Mortality.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.2

Comparison 3 LC versus SIC ‐ high‐quality and low‐quality trials regarding blinding, Outcome 2 Intra‐operative complications.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.3

Comparison 3 LC versus SIC ‐ high‐quality and low‐quality trials regarding blinding, Outcome 3 Minor complications.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.4

Comparison 3 LC versus SIC ‐ high‐quality and low‐quality trials regarding blinding, Outcome 4 Severe complications (without bile duct injuries).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.5

Comparison 3 LC versus SIC ‐ high‐quality and low‐quality trials regarding blinding, Outcome 5 Bile duct injuries.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.6

Comparison 3 LC versus SIC ‐ high‐quality and low‐quality trials regarding blinding, Outcome 6 Total complications.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.8

Comparison 3 LC versus SIC ‐ high‐quality and low‐quality trials regarding blinding, Outcome 8 Operative time (minutes).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.9

Comparison 3 LC versus SIC ‐ high‐quality and low‐quality trials regarding blinding, Outcome 9 Hospital stay (days).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.10

Comparison 3 LC versus SIC ‐ high‐quality and low‐quality trials regarding blinding, Outcome 10 Convalescence: work leave (days).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.11

Comparison 3 LC versus SIC ‐ high‐quality and low‐quality trials regarding blinding, Outcome 11 Convalescence: normal activity (at home) (days).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 4.1

Comparison 4 LC versus SIC ‐ high‐quality and low‐quality trials regarding follow‐up, Outcome 1 Mortality.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 4.2

Comparison 4 LC versus SIC ‐ high‐quality and low‐quality trials regarding follow‐up, Outcome 2 Intra‐operative complications.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 4.3

Comparison 4 LC versus SIC ‐ high‐quality and low‐quality trials regarding follow‐up, Outcome 3 Minor complications.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 4.4

Comparison 4 LC versus SIC ‐ high‐quality and low‐quality trials regarding follow‐up, Outcome 4 Severe complications (without bile duct injuries).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 4.5

Comparison 4 LC versus SIC ‐ high‐quality and low‐quality trials regarding follow‐up, Outcome 5 Bile duct injuries.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 4.6

Comparison 4 LC versus SIC ‐ high‐quality and low‐quality trials regarding follow‐up, Outcome 6 Total complications.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 4.7

Comparison 4 LC versus SIC ‐ high‐quality and low‐quality trials regarding follow‐up, Outcome 7 Conversions.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 4.8

Comparison 4 LC versus SIC ‐ high‐quality and low‐quality trials regarding follow‐up, Outcome 8 Operative time (minutes).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 4.9

Comparison 4 LC versus SIC ‐ high‐quality and low‐quality trials regarding follow‐up, Outcome 9 Hospital stay (days).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 4.10

Comparison 4 LC versus SIC ‐ high‐quality and low‐quality trials regarding follow‐up, Outcome 10 Convalescence: work leave (days).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 4.11

Comparison 4 LC versus SIC ‐ high‐quality and low‐quality trials regarding follow‐up, Outcome 11 Convalescence: normal activity (at home) (days).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 5.1

Comparison 5 LC versus SIC ‐ sensitivity and subgroup analyses, Outcome 1 Sensitivity analysis 1: Assuming zero mortality in nonreporting trials.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 5.2

Comparison 5 LC versus SIC ‐ sensitivity and subgroup analyses, Outcome 2 Sensitivity analysis 2: Assuming zero conversions in nonreporting trials.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 5.3

Comparison 5 LC versus SIC ‐ sensitivity and subgroup analyses, Outcome 3 Sensitivity analysis 3: Imputing medians and standard deviations for missing data in operative time (minutes).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 5.4

Comparison 5 LC versus SIC ‐ sensitivity and subgroup analyses, Outcome 4 Sensitivity analysis 4: Imputing medians and standard deviations for missing data in hospital stay (days).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 5.5

Comparison 5 LC versus SIC ‐ sensitivity and subgroup analyses, Outcome 5 Sensitivity analysis 5: Imputing medians and standard deviations for missing data in convalescence: work leave.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 5.6

Comparison 5 LC versus SIC ‐ sensitivity and subgroup analyses, Outcome 6 Sensitivity analysis 6: Imputing medians and standard deviations for missing data in normal activity.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 5.7

Comparison 5 LC versus SIC ‐ sensitivity and subgroup analyses, Outcome 7 Sensitivity analysis 7: Omitting outlier Srivastava in minor complications.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 5.8

Comparison 5 LC versus SIC ‐ sensitivity and subgroup analyses, Outcome 8 Sensitivity analysis 8: Omitting outlier Srivastava in total complications.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 5.9

Comparison 5 LC versus SIC ‐ sensitivity and subgroup analyses, Outcome 9 Sensitivity analysis 9: Omitting outlier Grande in hospital stay (days).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 5.10

Comparison 5 LC versus SIC ‐ sensitivity and subgroup analyses, Outcome 10 Sensitivity analysis 10: Total complications including Redmond.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 5.11

Comparison 5 LC versus SIC ‐ sensitivity and subgroup analyses, Outcome 11 Sensitivity analysis 11: Operative time (minutes) including Redmond.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 5.12

Comparison 5 LC versus SIC ‐ sensitivity and subgroup analyses, Outcome 12 Subgroup analysis 1: Influence antibiotic prophylaxis on total complications.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 5.13

Comparison 5 LC versus SIC ‐ sensitivity and subgroup analyses, Outcome 13 Subgroup analysis 2: Influence surgical experience on total complications.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 5.14

Comparison 5 LC versus SIC ‐ sensitivity and subgroup analyses, Outcome 14 Subgroup analysis 3: Influence cholangiography on operative time (minutes).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 5.15

Comparison 5 LC versus SIC ‐ sensitivity and subgroup analyses, Outcome 15 Subgroup analysis 4: Influence surgical experience on operative time (minutes).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 5.16

Comparison 5 LC versus SIC ‐ sensitivity and subgroup analyses, Outcome 16 Subgroup analysis 5: Influence antibiotic prophylaxis on hospital stay (days).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 5.17

Comparison 5 LC versus SIC ‐ sensitivity and subgroup analyses, Outcome 17 Subgroup analysis 6: Influence surgical experience on hospital stay (days).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 5.18

Comparison 5 LC versus SIC ‐ sensitivity and subgroup analyses, Outcome 18 Subgroup analysis 7: Influence cholangiography on bile duct injuries.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Table 1. Randomised, excluded, and included in LC versus SIC

Trial	Randomised	Excluded	Included LC	Included SIC	cholangiography	antibiotics	surgical expertise
Barkun 1992	70	8	37	25	N	Y	SS
Bruce 1999	22	0	11	11	U	Y	SS
Coelho 1993	45*	0	15	15	U	U	U
Grande 2002	40	0	18	22	N	Y	U
Keus 2006	270	13	120	137	N	Y	R
Kunz 1992	100	0	50	50	U	U	U
Majeed 1996	203	3	100	100	Y	U	SS
McGinn 1995	310	0	155	155	N	U	R
McMahon 1994	302	3	151	148	N	Y	R
Ros 2001	726	2	362	362	Y	U	R
Secco 2002	181	9	86	86	N	Y	S
Srivastava 2001	100	1	59	40	N	U	SS
Tate 1993	22	0	11	11	U	U	SS
Total	2391	39	1175	1162
* three‐arm trial, patients in the OC group not listed in this table.	N = no	Y = yes	U = unknown	S = one surgeon	SS = a few surgeons	R = also registrars

Table 1. Randomised, excluded, and included in LC versus SIC

Ir a la tabla de la revisión

Table 2. Description of background data (age, sex, BMI, and ASA)

Trial	N	Age	Age	Sex (m/f)	Sex (m/f)	BMI	BMI	ASA (I‐II‐III‐IV)	ASA (I‐II‐III‐IV)
LC vs SIC	randomised	LC	SIC	LC	SIC	LC	SIC	LC	SIC
Barkun 1992	37 / 25	51.4 (16.1)	52.3 (18.7)	11 / 26	6 / 19	25.8 (4.6)	27.5 (5.8)	31 ‐ ? ‐ ? ‐ ?	23 ‐ ? ‐ ? ‐ ?
Bruce 1999	11 / 11	48* (37‐56)$	48* (37‐63)$	2 / 9	2 / 9	26.5* (23‐29)$	26.3* (24‐31)$	‐	‐
Coelho 1993	15 / 15	42.7 (25‐70)	42.5 (25‐66)	3 / 12	2 / 13	‐	‐	‐	‐
Grande 2002	18 / 22	41.3 (9.7)	42.3 (9.7)	6 / 12	12 / 10	‐	‐	‐	‐
Keus 2006	120 / 137	48.4 (14.1)	48.5 (14.0)	31 / 89	30 / 107	27.5 (4.8)	27.9 (4.6)	81 ‐ 39 ‐ 0 ‐ 0	91 ‐ 46 ‐ 0 ‐ 0
Kunz 1992	50 / 50	nd	nd	nd	nd	‐	‐	‐	‐
Majeed 1996	100 / 100	48.9 (14.6)	51.1 (15)	20 / 80	19 / 81	27.4 (4.5)	26.6 (4.6)	58 ‐ 39 ‐ 3 ‐ 0	56 ‐ 36 ‐ 8 ‐ 0
McGinn 1995	150 / 150	53* (18‐81)	57* (26‐84)	42 / 108	46 / 104	25 (3.6)	26 (5.3)	‐	‐
McMahon 1994	151 / 148	54* (41‐64)	52* (41‐63)	18 / 133	24 / 124	26.7 (4.8)	26.1 (4.8)	66 ‐ 61 ‐ 19 ‐ 5	66 ‐ 51 ‐ 25 ‐ 6
Ros 2001	362 / 362	50.3 (15.1)	50.9 (16.1)	110 / 252	113 / 249	27.3 (4.3)	26.6 (4.4)	346 ‐ 14 ‐ 0	346 ‐ 14 ‐ 0
Secco 2002	86 / 86	54* (23‐83)	52* (19‐76)	34 / 52	31 / 55	‐	‐	‐	‐
Srivastava 2001	59 / 40	41.1 (37‐44)^	39.2 (35‐42)^	4 / 55	9 / 31	‐	‐	‐	‐
Tate 1993	11 / 11	38.6 (10.5)	49.9 (11.9)	‐	‐	‐	‐	‐	‐
* median	^ confidence interval	$ inter quartile range	nd: 'no difference' reported

Table 2. Description of background data (age, sex, BMI, and ASA)

Ir a la tabla de la revisión

Table 3. Complications specified per operative technique: LC versus SIC

Complications	LC	SIC
INTRA‐OPERATIVE	(153 / 13.1%)	(88 / 7.6%)
galbladder perforation	112	62
bleeding	23	19
stone in common bile duct	0	1
stone left in abdomen	10	0
vascular injury (hepatic artery)	0	1
bowel injury	5	3
hepatic injury	1	1
cardiac	1	1
cerebrovascular	1	0

POSTOPERATIVE ‐ MINOR	(97 / 8.3%)	(106 / 9.2%)
thrombo‐embolic event	2	1
retained bile duct stone (ERCP)	4	1
subcutaneous emphysema	1	0
wound infection	36	52
wound hematoma	6	0
urinary retention	8	18
urinary tract infection	5	11
flebitis	3	0
dyspeptic syndrome	11	12
other	21	11

POSTOPERATIVE ‐ SEVERE	(46 / 4.0%)	(48 / 4.2%)
bleeding: drainage / bloodtransfusion	11	4
bleeding: re‐operation	6	3
ileus (re‐operation)	1	2
pancreatitis	3	6
abscess (drainage / unspecified)	2	5
abscess (re‐operation)	1	1
pneumonia	14	18
septic shock	2	0
septic shock (re‐operation)	0	1
cardiovascular	2	6
cerebrovascular accident	1	1
hernia cicatricalis	2	1
epididymitis (re‐operation)	1	0

BILE DUCT INJURY	(14 / 1.2%)	(22 / 1.9%)
cystic duct leakage: drainage/ERCP	2	1
cystic duct leakage: re‐operation	0	3
accessory duct leakage (re‐operation)	0	1
minor common bile duct injury (intra‐operative)	5	3
major common bile duct injury: re‐operation	3	2
hepatic duct injury (intra‐operative)	0	1
bile leakage (origin unknown): conservative	2	8
bile leakage (origin unknown): re‐operation	2	3

TOTAL COMPLICATIONS	310 (26.6%)	264 (22.9%)
RE‐OPERATIONS (all complications)	19 (1.6%)	18 (1.6%)
TOTAL NUMBER OF PATIENTS INCLUDED (all trials)	1175	1162

Table 3. Complications specified per operative technique: LC versus SIC

Ir a la tabla de la revisión

Table 4. Internal validity assessment of included trials: LC vs SIC

Trial	Generation of alloc	Concealment of alloc	Blinding	Follow‐up
Barkun 1992	A	U	N	A
Bruce 1999	A	A	N	U
Coelho 1993	U	U	N	U
Grande 2002	U	A	N	U
Keus 2006	A	A	A	A
Kunz 1992	U	U	N	U
Majeed 1996	U	A	A	A
McGinn 1995	U	A	N	A
McMahon 1994	U	A	N	A
Ros 2001	U	A	A	A
Secco 2002	U	U	N	A
Srivastava 2001	U	A	N	A
Tate 1993	U	U	A	U
A: Adequate	U: Unclear	I: Inadequate	N: Not performed

Table 4. Internal validity assessment of included trials: LC vs SIC

Ir a la tabla de la revisión

Table 5. Results of LC vs SIC: allocation concealment (comparison 2)

Outcome	RD/WMD	HQ/LQ/AT	Fixed	Random	Discrepancy	Emphasize	HQ‐LQ difference	Significant
intraoperative complications	RD	HQ	0.07 (0.04, 0.09) *	0.02 (‐0.04, 0.08)	yes
		LQ	0.00 (‐0.02, 0.02)	0.00 (‐0.02, 0.02)	no
		AT	0.06 (0.03, 0.08) *	0.01 (‐0.03, 0.06)	yes	random	no	no
total complications	RD	HQ	0.04 (0.01, 0.08) *	‐0.01 (‐0.09, 0.07)	yes
		LQ	0.01 (‐0.05, 0.08)	‐0.01 (‐0.06, 0.05)	no
		AT	0.04 (0.01, 0.07) *	‐0.01 (‐0.07, 0.05)	yes	random	no	no
conversion rate	RD	HQ	‐0.03 (‐0.06, 0.00)	‐0.01 (‐0.07, 0.04)	no
		LQ	0.01 (‐0.04, 0.07)	0.02 (‐0.03, 0.07)	no
		AT	‐0.02 (‐0.05, 0.01)	0.00 (‐0.05, 0.04)	no	random	no	no
operative time	WMD	HQ	13.06 (10.44, 15.67) *	12.13 (5.60, 18.65) *	no
		LQ	‐1.34 (‐3.90, 1.22)	1.55 (‐6.30, 9.41)	no
		AT	5.70 (3.87, 7.53) *	9.20 (2.06, 16.35) *	no	random	yes	yes
hospital stay	WMD	HQ	‐0.65 (‐0.95, ‐0.35) *	‐0.72 (‐1.48, 0.04)	yes
		LQ	‐0.63 (‐0.94, ‐0.32) *	‐1.09 (‐2.01, ‐0.16) *	no
		AT	‐0.64 (‐0.85, ‐0.43) *	‐0.85 (‐1.35, ‐0.34) *	no	random	yes	no
convalescence work leave	WMD	HQ	‐0.30 (‐0.83, 0.23)	‐0.69 (‐3.61, 2.23)	no
		LQ	no data	no data	‐
		AT	‐0.30 (‐0.83, 0.23)	‐0.69 (‐3.61, 2.23)	no	random	‐	no
convalescence activity	WMD	HQ	‐1.87 (‐2.93, ‐0.80) *	0.79 (‐5.96, 7.55)	yes
		LQ	‐4.78 (‐6.99, ‐2.57) *	‐4.85 (‐7.28, ‐2.41) *	no
		AT	‐2.42 (‐3.38, ‐1.45) *	‐2.50 (‐5.54, 0.55) *	yes	random	yes	no
* significant result	HQ: high quality trials	LQ: low quality trials	AT: all trials

Table 5. Results of LC vs SIC: allocation concealment (comparison 2)

Ir a la tabla de la revisión

Table 6. Complications specified per operative technique: LC vs SIC: high‐quality trials

Complications	LC	SIC
INTRA‐OPERATIVE	(153 / 26.3%)	(87 / 14.5%)
gallbladder perforation	112	62
bleeding	23	19
stone left in abdomen	10	0
vascular injury (hepatic artery)	0	1
bowel injury	5	3
hepatic injury	1	1
cardiac	1	1
cerebrovascular	1	0

POSTOPERATIVE ‐ MINOR	(57 / 9.8%)	(58 / 9.7%)
thrombo‐embolic event	0	1
retained bile duct stone (ERCP)	0	1
wound infection	21	25
wound hematoma	2	0
urinary retention	6	11
urinary tract infection	5	9
flebitis	3	0
other	20	11

POSTOPERATIVE ‐ SEVERE	(27 / 4.6%)	(34 / 5.7%)
bleeding: drainage / blood transfusion	3	2
bleeding: re‐operation	4	4
pancreatitis	3	6
abscess (drainage / unspecified)	1	4
abscess (re‐operation)	1	0
pneumonia	12	12
cardiovascular	1	5
cerebrovascular accident	1	1
epididymitis (re‐operation)	1	0

BILE DUCT INJURY	(8 / 1.4%)	(10 / 1.7%)
cystic duct leakage: drainage/ERCP	1	1
cystic duct leakage: re‐operation	0	3
accessory duct leakage (re‐operation)	0	1
common bile duct injury (intra‐operative)	5	1
major common bile duct injury: re‐operation	2	1
hepatic duct injury (intra‐operative)	0	1
bile leakage (origin unknown): re‐operation	0	2

TOTAL COMPLICATIONS	245 (42.1%)	189 (31.6%)
RE‐OPERATIONS (all complications)	10 (1.7%)	12 (2.0%)
TOTAL NUMBER OF PATIENTS INCLUDED	582	599

Table 6. Complications specified per operative technique: LC vs SIC: high‐quality trials

Ir a la tabla de la revisión

Table 7. Operative time LC versus SIC: all available data

Trial	Type of data	LC ‐ mean/median	LC ‐ SD/range	SIC ‐ mean/median	SIC ‐ SD/range	Skewness LC	Skewness SIC
Barkun 1992	A ‐ SD	85.9	32	73.1	24.5	2.68	2.98
Bruce 1999	M ‐ IQR	57	50 ‐ 90	90	62 ‐ 99	‐	‐
Coelho 1993	A ‐ range	107	55 ‐ 150	74	40 ‐ 125	‐	‐
Grande 2002	A ‐ SD	42.95	24	32.00	8.0	1.79	4.00
Keus 2006	A ‐ SD	71.85	25.83	60.41	18.29	2.78	3.30
Kunz 1992	A ‐ SD	102	35	102	32	2.91	3.19
Majeed 1996	A ‐ SD	69.2	24.6	45.4	19.8	2.81	2.29
McGinn 1995	M ‐ range	74	45 ‐ 150	50	35 ‐ 150
McMahon 1994	A ‐ SD	71	20	57	24	3.55	2.38
Ros 2001	A ‐ SD	108	45	94	45	2.40	2.09
Secco 2002	A ‐ SD	35.7	11.2	37.6	5.7	3.19	6.60
Srivastava 2001	A ‐ CI *	54.2	48.7 ‐ 59.6 (20.93)*	57.2	51.5 ‐ 62.9 (17.85)*	2.59	3.20
Tate 1993	‐	‐	‐	‐	‐	‐	‐
A: average / mean	M: median	SD: standard deviation	CI: confidence interval	IQR: interquartile range
* SD calculated from CI

Table 7. Operative time LC versus SIC: all available data

Ir a la tabla de la revisión

Table 8. Hospital stay LC versus SIC: all available data

Trial	Type of data	LC ‐ mean/median	LC ‐ SD/range	SIC ‐ mean/median	SIC ‐ SD/range	Skewness LC	Skewness SIC
Barkun 1992	M ‐ range	3	1 ‐ 13	4	1 ‐ 6	‐	‐
Bruce 1999	‐	‐	‐	‐	‐	‐	‐
Coelho 1993	A ‐ range	1	1 ‐ 1	1	1 ‐ 1	‐	‐
Grande 2002	A ‐ SD	3.18	1.07	5.2	1.1	2.97	4.73
Keus 2006	A ‐ SD	2.38	4.58	3.08	12.37	0.52	0.25
Kunz 1992	A ‐ SD	3.8	2.3	5.6	3.1	1.65	1.81
Majeed 1996	A ‐ SD	3.6	2.3	3.5	2.1	1.57	1.67
McGinn 1995	M ‐ range	2	0 ‐ 7	3	1 ‐ 8	‐	‐
McMahon 1994	M ‐	2	‐	4	‐	‐	‐
Ros 2001	A ‐ SD	2.6	3.3	3.2	5.1	0.79	0.63
Secco 2002	A ‐ SD	3.6	1.3	4	1.0	2.77	4.00
Srivastava 2001	A ‐ CI	1.2	0.9 ‐ 1.6 (1.33)*	1.62	1.19 ‐ 2.0 (1.25)*	0.90	1.30
Tate 1993	A ‐ SD	1.45	0.69	2.82	1.4	2.10	2.01
* SD calculated from CI	A: Average / mean	SD: standard deviation	M: median	CI: confidence interval

Table 8. Hospital stay LC versus SIC: all available data

Ir a la tabla de la revisión

Comparison 1. LC versus SIC ‐ high‐quality and low‐quality trials regarding generation of the allocation sequence

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Mortality Show forest plot	7	1952	Risk Difference (M‐H, Fixed, 95% CI)	‐0.00 [‐0.01, 0.01]

1.1 High‐quality trials	2	319	Risk Difference (M‐H, Fixed, 95% CI)	0.0 [‐0.02, 0.02]
1.2 Low‐quality trials	5	1633	Risk Difference (M‐H, Fixed, 95% CI)	‐0.00 [‐0.01, 0.01]
2 Intra‐operative complications Show forest plot	12	2315	Risk Difference (M‐H, Random, 95% CI)	0.01 [‐0.03, 0.06]

2.1 High‐quality trials	3	341	Risk Difference (M‐H, Random, 95% CI)	0.01 [‐0.02, 0.05]
2.2 Low‐quality trials	9	1974	Risk Difference (M‐H, Random, 95% CI)	0.02 [‐0.04, 0.07]
3 Minor complications Show forest plot	12	2315	Risk Difference (M‐H, Random, 95% CI)	‐0.01 [‐0.04, 0.02]

3.1 High‐quality trials	3	341	Risk Difference (M‐H, Random, 95% CI)	‐0.01 [‐0.06, 0.05]
3.2 Low‐quality trials	9	1974	Risk Difference (M‐H, Random, 95% CI)	‐0.01 [‐0.05, 0.02]
4 Severe complications (without bile duct injuries) Show forest plot	12	2315	Risk Difference (M‐H, Random, 95% CI)	0.01 [‐0.01, 0.03]

4.1 High‐quality trials	3	341	Risk Difference (M‐H, Random, 95% CI)	0.04 [0.00, 0.07]
4.2 Low‐quality trials	9	1974	Risk Difference (M‐H, Random, 95% CI)	0.00 [‐0.02, 0.03]
5 Bile duct injuries Show forest plot	12	2315	Risk Difference (M‐H, Fixed, 95% CI)	‐0.01 [‐0.02, 0.00]

5.1 High‐quality trials	3	341	Risk Difference (M‐H, Fixed, 95% CI)	‐0.02 [‐0.05, 0.01]
5.2 Low‐quality trials	9	1974	Risk Difference (M‐H, Fixed, 95% CI)	‐0.01 [‐0.02, 0.01]
6 Total complications Show forest plot	12	2315	Risk Difference (M‐H, Random, 95% CI)	‐0.01 [‐0.07, 0.05]

6.1 High‐quality trials	3	341	Risk Difference (M‐H, Random, 95% CI)	0.01 [‐0.06, 0.09]
6.2 Low‐quality trials	9	1974	Risk Difference (M‐H, Random, 95% CI)	‐0.02 [‐0.09, 0.06]
7 Conversions Show forest plot	8	2132	Risk Difference (M‐H, Random, 95% CI)	‐0.00 [‐0.05, 0.04]

7.1 High‐quality trials	2	319	Risk Difference (M‐H, Random, 95% CI)	‐0.01 [‐0.09, 0.08]
7.2 Low‐quality trials	6	1813	Risk Difference (M‐H, Random, 95% CI)	‐0.00 [‐0.06, 0.05]
8 Operative time (minutes) Show forest plot	9	1953	Mean Difference (IV, Random, 95% CI)	9.20 [2.06, 16.35]

8.1 High‐quality trials	2	319	Mean Difference (IV, Random, 95% CI)	11.62 [6.46, 16.78]
8.2 Low‐quality trials	7	1634	Mean Difference (IV, Random, 95% CI)	8.44 [‐0.28, 17.16]
9 Hospital stay (days) Show forest plot	8	1614	Mean Difference (IV, Random, 95% CI)	‐0.85 [‐1.35, ‐0.34]

9.1 High‐quality trials	1	257	Mean Difference (IV, Random, 95% CI)	‐0.70 [‐2.93, 1.53]
9.2 Low‐quality trials	7	1357	Mean Difference (IV, Random, 95% CI)	‐0.86 [‐1.39, ‐0.32]
10 Convalescence: work leave (days) Show forest plot	3	1181	Mean Difference (IV, Random, 95% CI)	‐0.43 [‐4.37, 3.51]

10.1 High‐quality trials	1	257	Mean Difference (IV, Random, 95% CI)	0.77 [‐3.22, 4.76]
10.2 Low‐quality trials	2	924	Mean Difference (IV, Random, 95% CI)	‐0.73 [‐6.63, 5.18]
11 Convalescence: normal activity (at home) (days) Show forest plot	4	1158	Mean Difference (IV, Random, 95% CI)	‐2.50 [‐5.54, 0.55]

11.1 High‐quality trials	1	62	Mean Difference (IV, Random, 95% CI)	‐8.30 [‐15.40, ‐1.20]
11.2 Low‐quality trials	3	1096	Mean Difference (IV, Random, 95% CI)	‐1.72 [‐4.82, 1.38]

Comparison 1. LC versus SIC ‐ high‐quality and low‐quality trials regarding generation of the allocation sequence

Ir a la tabla de la revisión

Comparison 2. LC versus SIC ‐ high‐quality and low‐quality trials regarding allocation concealment

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Mortality Show forest plot	7	1952	Risk Difference (M‐H, Fixed, 95% CI)	‐0.00 [‐0.01, 0.01]

1.1 High‐quality trials	5	1790	Risk Difference (M‐H, Fixed, 95% CI)	‐0.00 [‐0.01, 0.01]
1.2 Low‐quality trials	2	162	Risk Difference (M‐H, Fixed, 95% CI)	0.0 [‐0.03, 0.03]
2 Intra‐operative complications Show forest plot	12	2315	Risk Difference (M‐H, Random, 95% CI)	0.01 [‐0.03, 0.06]

2.1 High‐quality trials	8	1951	Risk Difference (M‐H, Random, 95% CI)	0.02 [‐0.04, 0.08]
2.2 Low‐quality trials	4	364	Risk Difference (M‐H, Random, 95% CI)	0.0 [‐0.02, 0.02]
3 Minor complications Show forest plot	12	2315	Risk Difference (M‐H, Random, 95% CI)	‐0.01 [‐0.04, 0.02]

3.1 High‐quality trials	8	1951	Risk Difference (M‐H, Random, 95% CI)	‐0.02 [‐0.06, 0.03]
3.2 Low‐quality trials	4	364	Risk Difference (M‐H, Random, 95% CI)	‐0.01 [‐0.04, 0.03]
4 Severe complications (without bile duct injuries) Show forest plot	12	2315	Risk Difference (M‐H, Random, 95% CI)	0.01 [‐0.01, 0.03]

4.1 High‐quality trials	8	1951	Risk Difference (M‐H, Random, 95% CI)	0.00 [‐0.03, 0.03]
4.2 Low‐quality trials	4	364	Risk Difference (M‐H, Random, 95% CI)	0.03 [‐0.01, 0.06]
5 Bile duct injuries Show forest plot	12	2315	Risk Difference (M‐H, Fixed, 95% CI)	‐0.01 [‐0.02, 0.00]

5.1 High‐quality trials	8	1951	Risk Difference (M‐H, Fixed, 95% CI)	‐0.01 [‐0.02, 0.01]
5.2 Low‐quality trials	4	364	Risk Difference (M‐H, Fixed, 95% CI)	‐0.01 [‐0.04, 0.01]
6 Total complications Show forest plot	12	2315	Risk Difference (M‐H, Random, 95% CI)	‐0.01 [‐0.07, 0.05]

6.1 High‐quality trials	8	1951	Risk Difference (M‐H, Random, 95% CI)	‐0.01 [‐0.09, 0.07]
6.2 Low‐quality trials	4	364	Risk Difference (M‐H, Random, 95% CI)	‐0.01 [‐0.06, 0.05]
7 Conversions Show forest plot	8	2132	Risk Difference (M‐H, Random, 95% CI)	‐0.00 [‐0.05, 0.04]

7.1 High‐quality trials	6	1889	Risk Difference (M‐H, Random, 95% CI)	‐0.01 [‐0.07, 0.04]
7.2 Low‐quality trials	2	243	Risk Difference (M‐H, Random, 95% CI)	0.02 [‐0.03, 0.07]
8 Operative time (minutes) Show forest plot	9	1953	Mean Difference (IV, Random, 95% CI)	9.20 [2.06, 16.35]

8.1 High‐quality trials	6	1619	Mean Difference (IV, Random, 95% CI)	12.13 [5.60, 18.65]
8.2 Low‐quality trials	3	334	Mean Difference (IV, Random, 95% CI)	1.55 [‐6.30, 9.41]
9 Hospital stay (days) Show forest plot	8	1614	Mean Difference (IV, Random, 95% CI)	‐0.85 [‐1.35, ‐0.34]

9.1 High‐quality trials	5	1320	Mean Difference (IV, Random, 95% CI)	‐0.72 [‐1.48, 0.04]
9.2 Low‐quality trials	3	294	Mean Difference (IV, Random, 95% CI)	‐1.09 [‐2.01, ‐0.16]
10 Convalescence: work leave (days) Show forest plot	3	1181	Mean Difference (IV, Random, 95% CI)	‐0.43 [‐4.37, 3.51]

10.1 High‐quality trials	3	1181	Mean Difference (IV, Random, 95% CI)	‐0.43 [‐4.37, 3.51]
10.2 Low‐quality trials	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
11 Convalescence: normal activity (at home) (days) Show forest plot	4	1158	Mean Difference (IV, Random, 95% CI)	‐2.50 [‐5.54, 0.55]

11.1 High‐quality trials	2	924	Mean Difference (IV, Random, 95% CI)	0.79 [‐5.96, 7.55]
11.2 Low‐quality trials	2	234	Mean Difference (IV, Random, 95% CI)	‐4.85 [‐7.28, ‐2.41]

Comparison 2. LC versus SIC ‐ high‐quality and low‐quality trials regarding allocation concealment

Ir a la tabla de la revisión

Comparison 3. LC versus SIC ‐ high‐quality and low‐quality trials regarding blinding

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Mortality Show forest plot	7	1952	Risk Difference (M‐H, Fixed, 95% CI)	‐0.00 [‐0.01, 0.01]

1.1 High‐quality trials	3	1181	Risk Difference (M‐H, Fixed, 95% CI)	0.0 [‐0.01, 0.01]
1.2 Low‐quality trials	4	771	Risk Difference (M‐H, Fixed, 95% CI)	‐0.00 [‐0.01, 0.01]
2 Intra‐operative complications Show forest plot	12	2315	Risk Difference (M‐H, Random, 95% CI)	0.01 [‐0.03, 0.06]

2.1 High‐quality trials	3	1181	Risk Difference (M‐H, Random, 95% CI)	0.07 [‐0.08, 0.21]
2.2 Low‐quality trials	9	1134	Risk Difference (M‐H, Random, 95% CI)	‐0.00 [‐0.01, 0.01]
3 Minor complications Show forest plot	12	2315	Risk Difference (M‐H, Random, 95% CI)	‐0.01 [‐0.04, 0.02]

3.1 High‐quality trials	3	1181	Risk Difference (M‐H, Random, 95% CI)	0.00 [‐0.03, 0.03]
3.2 Low‐quality trials	9	1134	Risk Difference (M‐H, Random, 95% CI)	‐0.02 [‐0.06, 0.02]
4 Severe complications (without bile duct injuries) Show forest plot	12	2315	Risk Difference (M‐H, Random, 95% CI)	0.01 [‐0.01, 0.03]

4.1 High‐quality trials	3	1181	Risk Difference (M‐H, Random, 95% CI)	0.00 [‐0.04, 0.05]
4.2 Low‐quality trials	9	1134	Risk Difference (M‐H, Random, 95% CI)	0.01 [‐0.01, 0.04]
5 Bile duct injuries Show forest plot	12	2315	Risk Difference (M‐H, Fixed, 95% CI)	‐0.01 [‐0.02, 0.00]

5.1 High‐quality trials	3	1181	Risk Difference (M‐H, Fixed, 95% CI)	‐0.00 [‐0.02, 0.01]
5.2 Low‐quality trials	9	1134	Risk Difference (M‐H, Fixed, 95% CI)	‐0.01 [‐0.03, 0.00]
6 Total complications Show forest plot	12	2315	Risk Difference (M‐H, Random, 95% CI)	‐0.01 [‐0.07, 0.05]

6.1 High‐quality trials	3	1181	Risk Difference (M‐H, Random, 95% CI)	0.07 [‐0.03, 0.16]
6.2 Low‐quality trials	9	1134	Risk Difference (M‐H, Random, 95% CI)	‐0.04 [‐0.11, 0.03]
8 Operative time (minutes) Show forest plot	9	1953	Mean Difference (IV, Random, 95% CI)	9.20 [2.06, 16.35]

8.1 High‐quality trials	3	1181	Mean Difference (IV, Random, 95% CI)	16.36 [8.88, 23.83]
8.2 Low‐quality trials	6	772	Mean Difference (IV, Random, 95% CI)	5.09 [‐2.66, 12.83]
9 Hospital stay (days) Show forest plot	8	1614	Mean Difference (IV, Random, 95% CI)	‐0.85 [‐1.35, ‐0.34]

9.1 High‐quality trials	4	1203	Mean Difference (IV, Random, 95% CI)	‐0.56 [‐1.24, 0.11]
9.2 Low‐quality trials	4	411	Mean Difference (IV, Random, 95% CI)	‐1.08 [‐1.88, ‐0.28]
10 Convalescence: work leave (days) Show forest plot	3	1181	Mean Difference (IV, Random, 95% CI)	‐0.43 [‐4.37, 3.51]

10.1 High‐quality trials	3	1181	Mean Difference (IV, Random, 95% CI)	‐0.43 [‐4.37, 3.51]
10.2 Low‐quality trials	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
11 Convalescence: normal activity (at home) (days) Show forest plot	4	1158	Mean Difference (IV, Random, 95% CI)	‐2.50 [‐5.54, 0.55]

11.1 High‐quality trials	2	924	Mean Difference (IV, Random, 95% CI)	0.79 [‐5.96, 7.55]
11.2 Low‐quality trials	2	234	Mean Difference (IV, Random, 95% CI)	‐4.85 [‐7.28, ‐2.41]

Comparison 3. LC versus SIC ‐ high‐quality and low‐quality trials regarding blinding

Ir a la tabla de la revisión

Comparison 4. LC versus SIC ‐ high‐quality and low‐quality trials regarding follow‐up

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Mortality Show forest plot	7	1952	Risk Difference (M‐H, Fixed, 95% CI)	‐0.00 [‐0.01, 0.01]

1.1 High‐quality trials	6	1852	Risk Difference (M‐H, Fixed, 95% CI)	‐0.00 [‐0.01, 0.01]
1.2 Low‐quality trials	1	100	Risk Difference (M‐H, Fixed, 95% CI)	0.0 [‐0.04, 0.04]
2 Intra‐operative complications Show forest plot	12	2315	Risk Difference (M‐H, Random, 95% CI)	0.01 [‐0.03, 0.06]

2.1 High‐quality trials	8	2123	Risk Difference (M‐H, Random, 95% CI)	0.02 [‐0.03, 0.07]
2.2 Low‐quality trials	4	192	Risk Difference (M‐H, Random, 95% CI)	0.0 [‐0.03, 0.03]
3 Minor complications Show forest plot	12	2315	Risk Difference (M‐H, Random, 95% CI)	‐0.01 [‐0.04, 0.02]

3.1 High‐quality trials	8	2123	Risk Difference (M‐H, Random, 95% CI)	‐0.02 [‐0.06, 0.02]
3.2 Low‐quality trials	4	192	Risk Difference (M‐H, Random, 95% CI)	‐0.00 [‐0.04, 0.03]
4 Severe complications (without bile duct injuries) Show forest plot	12	2315	Risk Difference (M‐H, Random, 95% CI)	0.01 [‐0.01, 0.03]

4.1 High‐quality trials	8	2123	Risk Difference (M‐H, Random, 95% CI)	0.01 [‐0.02, 0.04]
4.2 Low‐quality trials	4	192	Risk Difference (M‐H, Random, 95% CI)	0.01 [‐0.04, 0.06]
5 Bile duct injuries Show forest plot	12	2315	Risk Difference (M‐H, Fixed, 95% CI)	‐0.01 [‐0.02, 0.00]

5.1 High‐quality trials	8	2123	Risk Difference (M‐H, Fixed, 95% CI)	‐0.01 [‐0.02, 0.00]
5.2 Low‐quality trials	4	192	Risk Difference (M‐H, Fixed, 95% CI)	‐0.01 [‐0.06, 0.03]
6 Total complications Show forest plot	12	2315	Risk Difference (M‐H, Random, 95% CI)	‐0.01 [‐0.07, 0.05]

6.1 High‐quality trials	8	2123	Risk Difference (M‐H, Random, 95% CI)	‐0.01 [‐0.09, 0.07]
6.2 Low‐quality trials	4	192	Risk Difference (M‐H, Random, 95% CI)	‐0.01 [‐0.06, 0.05]
7 Conversions Show forest plot	8	2132	Risk Difference (M‐H, Random, 95% CI)	‐0.00 [‐0.05, 0.04]

7.1 High‐quality trials	8	2132	Risk Difference (M‐H, Random, 95% CI)	‐0.00 [‐0.05, 0.04]
7.2 Low‐quality trials	0	0	Risk Difference (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
8 Operative time (minutes) Show forest plot	9	1953	Mean Difference (IV, Random, 95% CI)	9.20 [2.06, 16.35]

8.1 High‐quality trials	7	1813	Mean Difference (IV, Random, 95% CI)	10.03 [1.79, 18.27]
8.2 Low‐quality trials	2	140	Mean Difference (IV, Random, 95% CI)	5.93 [‐4.76, 16.63]
9 Hospital stay (days) Show forest plot	8	1614	Mean Difference (IV, Random, 95% CI)	‐0.85 [‐1.35, ‐0.34]

9.1 High‐quality trials	5	1452	Mean Difference (IV, Random, 95% CI)	‐0.36 [‐0.60, ‐0.12]
9.2 Low‐quality trials	3	162	Mean Difference (IV, Random, 95% CI)	‐1.79 [‐2.28, ‐1.31]
10 Convalescence: work leave (days) Show forest plot	3	1181	Mean Difference (IV, Random, 95% CI)	‐0.43 [‐4.37, 3.51]

10.1 High‐quality trials	3	1181	Mean Difference (IV, Random, 95% CI)	‐0.43 [‐4.37, 3.51]
10.2 Low‐quality trials	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
11 Convalescence: normal activity (at home) (days) Show forest plot	4	1158	Mean Difference (IV, Random, 95% CI)	‐2.50 [‐5.54, 0.55]

11.1 High‐quality trials	4	1158	Mean Difference (IV, Random, 95% CI)	‐2.50 [‐5.54, 0.55]
11.2 Low‐quality trials	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]

Comparison 4. LC versus SIC ‐ high‐quality and low‐quality trials regarding follow‐up

Ir a la tabla de la revisión

Comparison 5. LC versus SIC ‐ sensitivity and subgroup analyses

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Sensitivity analysis 1: Assuming zero mortality in nonreporting trials Show forest plot	13	2337	Risk Difference (M‐H, Fixed, 95% CI)	‐0.00 [‐0.01, 0.01]

2 Sensitivity analysis 2: Assuming zero conversions in nonreporting trials Show forest plot	13	2346	Risk Difference (M‐H, Fixed, 95% CI)	‐0.02 [‐0.05, 0.01]

3 Sensitivity analysis 3: Imputing medians and standard deviations for missing data in operative time (minutes) Show forest plot	12	2315	Mean Difference (IV, Random, 95% CI)	9.71 [2.34, 17.08]

4 Sensitivity analysis 4: Imputing medians and standard deviations for missing data in hospital stay (days) Show forest plot	12	2315	Mean Difference (IV, Random, 95% CI)	‐0.96 [‐1.41, ‐0.51]

5 Sensitivity analysis 5: Imputing medians and standard deviations for missing data in convalescence: work leave Show forest plot	6	1890	Mean Difference (IV, Random, 95% CI)	‐5.86 [‐12.31, 0.59]

6 Sensitivity analysis 6: Imputing medians and standard deviations for missing data in normal activity Show forest plot	7	1867	Mean Difference (IV, Random, 95% CI)	‐7.42 [‐15.94, 1.10]

7 Sensitivity analysis 7: Omitting outlier Srivastava in minor complications Show forest plot	11	2216	Risk Difference (M‐H, Random, 95% CI)	0.00 [‐0.01, 0.02]

8 Sensitivity analysis 8: Omitting outlier Srivastava in total complications Show forest plot	11	2216	Risk Difference (M‐H, Random, 95% CI)	0.02 [‐0.02, 0.07]

9 Sensitivity analysis 9: Omitting outlier Grande in hospital stay (days) Show forest plot	7	1574	Mean Difference (IV, Random, 95% CI)	‐0.59 [‐0.98, ‐0.21]

10 Sensitivity analysis 10: Total complications including Redmond Show forest plot	13	2359	Risk Difference (M‐H, Random, 95% CI)	‐0.03 [‐0.10, 0.03]

11 Sensitivity analysis 11: Operative time (minutes) including Redmond Show forest plot	13	2359	Mean Difference (IV, Random, 95% CI)	8.04 [0.82, 15.26]

12 Subgroup analysis 1: Influence antibiotic prophylaxis on total complications Show forest plot	12	2315	Risk Difference (M‐H, Random, 95% CI)	‐0.01 [‐0.07, 0.05]

12.1 Antibiotic: yes	6	852	Risk Difference (M‐H, Random, 95% CI)	0.00 [‐0.04, 0.05]
12.2 Antibiotic: no / unknown	6	1463	Risk Difference (M‐H, Random, 95% CI)	‐0.03 [‐0.14, 0.08]
13 Subgroup analysis 2: Influence surgical experience on total complications Show forest plot	9	2145	Risk Difference (M‐H, Random, 95% CI)	‐0.01 [‐0.09, 0.07]

13.1 Surgical experience: surgeon(s)	5	555	Risk Difference (M‐H, Random, 95% CI)	‐0.08 [‐0.22, 0.06]
13.2 Surgical experience: registrars	4	1590	Risk Difference (M‐H, Random, 95% CI)	0.06 [‐0.01, 0.13]
14 Subgroup analysis 3: Influence cholangiography on operative time (minutes) Show forest plot	12	2315	Mean Difference (IV, Random, 95% CI)	9.71 [2.34, 17.08]

14.1 Cholangiography: yes	2	924	Mean Difference (IV, Random, 95% CI)	18.96 [9.36, 28.57]
14.2 Cholangiography: no	10	1391	Mean Difference (IV, Random, 95% CI)	7.64 [‐0.50, 15.77]
15 Subgroup analysis 4: Influence surgical experience on operative time (minutes) Show forest plot	9	2145	Mean Difference (IV, Random, 95% CI)	8.58 [0.13, 17.03]

15.1 Surgical experience: surgeon(s)	5	555	Mean Difference (IV, Random, 95% CI)	1.47 [‐12.21, 15.15]
15.2 Surgical experience: registrars	4	1590	Mean Difference (IV, Random, 95% CI)	15.91 [10.31, 21.50]
16 Subgroup analysis 5: Influence antibiotic prophylaxis on hospital stay (days) Show forest plot	12	2315	Mean Difference (IV, Random, 95% CI)	‐0.96 [‐1.41, ‐0.51]

16.1 Antibiotic profylaxis: yes	5	830	Mean Difference (IV, Random, 95% CI)	‐1.29 [‐2.24, ‐0.35]
16.2 Antibiotic profylaxis: no / unknown	7	1485	Mean Difference (IV, Random, 95% CI)	‐0.71 [‐1.17, ‐0.25]
17 Subgroup analysis 6: Influence surgical experience on hospital stay (days) Show forest plot	9	2145	Mean Difference (IV, Random, 95% CI)	‐0.78 [‐1.22, ‐0.35]

17.1 Surgical experience: surgeon(s)	5	555	Mean Difference (IV, Random, 95% CI)	‐0.46 [‐0.84, ‐0.07]
17.2 Surgical experience: registrars	4	1590	Mean Difference (IV, Random, 95% CI)	‐1.15 [‐1.88, ‐0.43]
18 Subgroup analysis 7: Influence cholangiography on bile duct injuries Show forest plot	9	2163	Risk Difference (M‐H, Fixed, 95% CI)	‐0.01 [‐0.02, 0.00]

18.1 Cholangiography: yes	2	924	Risk Difference (M‐H, Fixed, 95% CI)	0.0 [‐0.02, 0.02]
18.2 Cholangiography: no	7	1239	Risk Difference (M‐H, Fixed, 95% CI)	‐0.01 [‐0.03, 0.00]

Comparison 5. LC versus SIC ‐ sensitivity and subgroup analyses

Ir a la tabla de la revisión

The Cochrane Library

Scolaris Language Selector Scolaris Language Selector

Idioma de la Revisión Cochrane

Idioma de la web

Scolaris Content Language Banner Portlet Scolaris Content Language Banner Portlet

Scolaris Content Display Scolaris Content Display

Temas

Scolaris Language Selector Scolaris Language Selector

Scolaris Content Display Scolaris Content Display

Instituciones a las que se accedió previamente

Scolaris Content Display Scolaris Content Display

Usuarios institucionales

Instituciones a las que se accedió previamente

Otras opciones de acceso

	Idioma de la Revisión Cochrane Escoja su idioma de preferencia para las revisiones Cochrane y otros contenidos. Las secciones sin una traducción aparecerán en inglés.

	Idioma de la web Escoja su idioma de preferencia para la web de la Biblioteca Cochrane.

Idioma de la Revisión Cochrane

Idioma de la web

Contenido relacionado

Revisiones y protocolos relacionados

Temas

Copiar o descargar referencia

Idioma de la Revisión Cochrane

Idioma de la web

Instituciones a las que se accedió previamente

Usuarios institucionales

Instituciones a las que se accedió previamente

Otras opciones de acceso