Scolaris Content Display Scolaris Content Display

Methodological quality graph: review authors' judgements about each methodological quality item presented as percentages across all included studies.
Figuras y tablas -
Figure 1

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

Methodological quality summary: review authors' judgements about each methodological quality item for each included study.
Figuras y tablas -
Figure 2

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

Funnel plot on laparoscopic versus open cholecystectomy regarding concealment of allocation considering total complications, including 95% confidence interval lines. No arguments for bias.
Figuras y tablas -
Figure 3

Funnel plot on laparoscopic versus open cholecystectomy regarding concealment of allocation considering total complications, including 95% confidence interval lines. No arguments for bias.

Comparison 1 LC versus OC ‐ high‐quality and low‐quality trials regarding generation of the allocation sequence, Outcome 1 Mortality.
Figuras y tablas -
Analysis 1.1

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

Comparison 1 LC versus OC ‐ high‐quality and low‐quality trials regarding generation of the allocation sequence, Outcome 2 Intra‐operative complications.
Figuras y tablas -
Analysis 1.2

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

Comparison 1 LC versus OC ‐ high‐quality and low‐quality trials regarding generation of the allocation sequence, Outcome 3 Minor complications.
Figuras y tablas -
Analysis 1.3

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

Comparison 1 LC versus OC ‐ high‐quality and low‐quality trials regarding generation of the allocation sequence, Outcome 4 Severe complications (without bile duct injuries).
Figuras y tablas -
Analysis 1.4

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

Comparison 1 LC versus OC ‐ high‐quality and low‐quality trials regarding generation of the allocation sequence, Outcome 5 Bile duct injuries.
Figuras y tablas -
Analysis 1.5

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

Comparison 1 LC versus OC ‐ high‐quality and low‐quality trials regarding generation of the allocation sequence, Outcome 6 Total complications.
Figuras y tablas -
Analysis 1.6

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

Comparison 1 LC versus OC ‐ high‐quality and low‐quality trials regarding generation of the allocation sequence, Outcome 7 Operative time (minutes).
Figuras y tablas -
Analysis 1.7

Comparison 1 LC versus OC ‐ high‐quality and low‐quality trials regarding generation of the allocation sequence, Outcome 7 Operative time (minutes).

Comparison 1 LC versus OC ‐ high‐quality and low‐quality trials regarding generation of the allocation sequence, Outcome 8 Hospital stay (days).
Figuras y tablas -
Analysis 1.8

Comparison 1 LC versus OC ‐ high‐quality and low‐quality trials regarding generation of the allocation sequence, Outcome 8 Hospital stay (days).

Comparison 1 LC versus OC ‐ high‐quality and low‐quality trials regarding generation of the allocation sequence, Outcome 9 Convalescence: work leave (days).
Figuras y tablas -
Analysis 1.9

Comparison 1 LC versus OC ‐ high‐quality and low‐quality trials regarding generation of the allocation sequence, Outcome 9 Convalescence: work leave (days).

Comparison 2 LC versus OC ‐ high‐quality and low‐quality trials regarding concealment of allocation, Outcome 1 Mortality.
Figuras y tablas -
Analysis 2.1

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

Comparison 2 LC versus OC ‐ high‐quality and low‐quality trials regarding concealment of allocation, Outcome 2 Intra‐operative complications.
Figuras y tablas -
Analysis 2.2

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

Comparison 2 LC versus OC ‐ high‐quality and low‐quality trials regarding concealment of allocation, Outcome 3 Minor complications.
Figuras y tablas -
Analysis 2.3

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

Comparison 2 LC versus OC ‐ high‐quality and low‐quality trials regarding concealment of allocation, Outcome 4 Severe complications (without bile duct injuries).
Figuras y tablas -
Analysis 2.4

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

Comparison 2 LC versus OC ‐ high‐quality and low‐quality trials regarding concealment of allocation, Outcome 5 Bile duct injuries.
Figuras y tablas -
Analysis 2.5

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

Comparison 2 LC versus OC ‐ high‐quality and low‐quality trials regarding concealment of allocation, Outcome 6 Total complications.
Figuras y tablas -
Analysis 2.6

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

Comparison 2 LC versus OC ‐ high‐quality and low‐quality trials regarding concealment of allocation, Outcome 7 Operative time (minutes).
Figuras y tablas -
Analysis 2.7

Comparison 2 LC versus OC ‐ high‐quality and low‐quality trials regarding concealment of allocation, Outcome 7 Operative time (minutes).

Comparison 2 LC versus OC ‐ high‐quality and low‐quality trials regarding concealment of allocation, Outcome 8 Hospital stay (days).
Figuras y tablas -
Analysis 2.8

Comparison 2 LC versus OC ‐ high‐quality and low‐quality trials regarding concealment of allocation, Outcome 8 Hospital stay (days).

Comparison 2 LC versus OC ‐ high‐quality and low‐quality trials regarding concealment of allocation, Outcome 9 Convalescence: work leave (days).
Figuras y tablas -
Analysis 2.9

Comparison 2 LC versus OC ‐ high‐quality and low‐quality trials regarding concealment of allocation, Outcome 9 Convalescence: work leave (days).

Comparison 3 LC versus OC ‐ high‐quality and low‐quality trials regarding blinding, Outcome 1 Mortality.
Figuras y tablas -
Analysis 3.1

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

Comparison 3 LC versus OC ‐ high‐quality and low‐quality trials regarding blinding, Outcome 2 Intra‐operative complications.
Figuras y tablas -
Analysis 3.2

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

Comparison 3 LC versus OC ‐ high‐quality and low‐quality trials regarding blinding, Outcome 3 Minor complications.
Figuras y tablas -
Analysis 3.3

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

Comparison 3 LC versus OC ‐ high‐quality and low‐quality trials regarding blinding, Outcome 4 Severe complications (without bile duct injuries).
Figuras y tablas -
Analysis 3.4

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

Comparison 3 LC versus OC ‐ high‐quality and low‐quality trials regarding blinding, Outcome 5 Bile duct injuries.
Figuras y tablas -
Analysis 3.5

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

Comparison 3 LC versus OC ‐ high‐quality and low‐quality trials regarding blinding, Outcome 6 Total complications.
Figuras y tablas -
Analysis 3.6

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

Comparison 3 LC versus OC ‐ high‐quality and low‐quality trials regarding blinding, Outcome 7 Operative time (minutes).
Figuras y tablas -
Analysis 3.7

Comparison 3 LC versus OC ‐ high‐quality and low‐quality trials regarding blinding, Outcome 7 Operative time (minutes).

Comparison 3 LC versus OC ‐ high‐quality and low‐quality trials regarding blinding, Outcome 8 Hospital stay (days).
Figuras y tablas -
Analysis 3.8

Comparison 3 LC versus OC ‐ high‐quality and low‐quality trials regarding blinding, Outcome 8 Hospital stay (days).

Comparison 3 LC versus OC ‐ high‐quality and low‐quality trials regarding blinding, Outcome 9 Convalescence: work leave (days).
Figuras y tablas -
Analysis 3.9

Comparison 3 LC versus OC ‐ high‐quality and low‐quality trials regarding blinding, Outcome 9 Convalescence: work leave (days).

Comparison 4 LC versus OC ‐ high‐quality and low‐quality trials regarding follow‐up, Outcome 1 Mortality.
Figuras y tablas -
Analysis 4.1

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

Comparison 4 LC versus OC ‐ high‐quality and low‐quality trials regarding follow‐up, Outcome 2 Intra‐operative complications.
Figuras y tablas -
Analysis 4.2

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

Comparison 4 LC versus OC ‐ high‐quality and low‐quality trials regarding follow‐up, Outcome 3 Minor complications.
Figuras y tablas -
Analysis 4.3

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

Comparison 4 LC versus OC ‐ high‐quality and low‐quality trials regarding follow‐up, Outcome 4 Severe complications (without bile duct injuries).
Figuras y tablas -
Analysis 4.4

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

Comparison 4 LC versus OC ‐ high‐quality and low‐quality trials regarding follow‐up, Outcome 5 Bile duct injuries.
Figuras y tablas -
Analysis 4.5

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

Comparison 4 LC versus OC ‐ high‐quality and low‐quality trials regarding follow‐up, Outcome 6 Total complications.
Figuras y tablas -
Analysis 4.6

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

Comparison 4 LC versus OC ‐ high‐quality and low‐quality trials regarding follow‐up, Outcome 7 Operative time (minutes).
Figuras y tablas -
Analysis 4.7

Comparison 4 LC versus OC ‐ high‐quality and low‐quality trials regarding follow‐up, Outcome 7 Operative time (minutes).

Comparison 4 LC versus OC ‐ high‐quality and low‐quality trials regarding follow‐up, Outcome 8 Hospital stay (days).
Figuras y tablas -
Analysis 4.8

Comparison 4 LC versus OC ‐ high‐quality and low‐quality trials regarding follow‐up, Outcome 8 Hospital stay (days).

Comparison 4 LC versus OC ‐ high‐quality and low‐quality trials regarding follow‐up, Outcome 9 Convalescence: work leave (days).
Figuras y tablas -
Analysis 4.9

Comparison 4 LC versus OC ‐ high‐quality and low‐quality trials regarding follow‐up, Outcome 9 Convalescence: work leave (days).

Comparison 5 LC versus OC ‐ sensitivity and subgroup analyses, Outcome 1 Sensitivity analysis 1: Assuming zero mortality in non‐reporting trials.
Figuras y tablas -
Analysis 5.1

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

Comparison 5 LC versus OC ‐ sensitivity and subgroup analyses, Outcome 2 Sensitivity analysis 2: Imputing medians and standard deviations for missing data in operative time (minutes).
Figuras y tablas -
Analysis 5.2

Comparison 5 LC versus OC ‐ sensitivity and subgroup analyses, Outcome 2 Sensitivity analysis 2: Imputing medians and standard deviations for missing data in operative time (minutes).

Comparison 5 LC versus OC ‐ sensitivity and subgroup analyses, Outcome 3 Sensitivity analysis 3: Imputing medians and standard deviations for missing data in hospital stay (days).
Figuras y tablas -
Analysis 5.3

Comparison 5 LC versus OC ‐ sensitivity and subgroup analyses, Outcome 3 Sensitivity analysis 3: Imputing medians and standard deviations for missing data in hospital stay (days).

Comparison 5 LC versus OC ‐ sensitivity and subgroup analyses, Outcome 4 Subgroup analysis 1: Influence antibiotic prophylaxis on total complications.
Figuras y tablas -
Analysis 5.4

Comparison 5 LC versus OC ‐ sensitivity and subgroup analyses, Outcome 4 Subgroup analysis 1: Influence antibiotic prophylaxis on total complications.

Comparison 5 LC versus OC ‐ sensitivity and subgroup analyses, Outcome 5 Subgroup analysis 2: Influence cholangiography on operative time (minutes).
Figuras y tablas -
Analysis 5.5

Comparison 5 LC versus OC ‐ sensitivity and subgroup analyses, Outcome 5 Subgroup analysis 2: Influence cholangiography on operative time (minutes).

Comparison 5 LC versus OC ‐ sensitivity and subgroup analyses, Outcome 6 Subgroup analysis 3: Influence antibiotic prophylaxis on hospital stay (days).
Figuras y tablas -
Analysis 5.6

Comparison 5 LC versus OC ‐ sensitivity and subgroup analyses, Outcome 6 Subgroup analysis 3: Influence antibiotic prophylaxis on hospital stay (days).

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

Trial

Randomised

Excluded

Included LC

Included OC

cholangiography

antibiotics

surgical expertise

Agnifili 1993

50

0

29

21

Y

U

U

Bellon 1998

28

0

14

14

N

U

U

Berggren 1994

30

3

15

12

N

N

SS

Blanc‐Louvry 2000

41

0

25

16

Y

U

S

Bukan 2004

30

0

15

15

U

U

U

Charlo 1995

200

0

100

100

U

U

U

Chaudhary 1999

43

0

21

22

U

Y

U

Chumillas 1998

40

0

20

20

N

U

U

Coelho 1993

45*

0

15

15

U

U

U

Coskun 2000

70

0

35

35

U

U

U

Dauleh 1995

78

0

40

38

U

N

S

Demirer 2000

100

0

50

50

N

N

SS

Dionigi 1994

57

0

30

27

N

U

SS

Engin 1998

32

0

16

16

U

U

SS

Essen 1995

12

0

6

6

Y

U

U

Gal 1997

42

0

21

21

U

Y

U

Galizia 2001

33

18

10

5

U

U

U

Garcia‐Caballero 1993

100

4

20

76

U

U

S

Hasukic 2002

60

2

30

28

U

U

SS

Hendolin 2000

49

2

25

22

N

U

S

Huang 1996

29

2

15

12

U

U

U

Jan 1993

101

0

50

51

U

U

U

Karayiannakis 1997

96

9

45

42

U

U

SS

Kjaersgaard 1994

72

2

35

35

U

U

U

Koprulu 1996

40

0

20

20

U

U

U

Lausten 1999 ‐ 1 (postnecrotic cirrosis)

16

2

7

7

N

U

SS

Lausten 1999 ‐ 2 (chronic hepatitis)

14

0

7

7

N

U

SS

Lujan 1998

285

21

133

131

Y

Y

U

Luo 2003

26

0

14

12

U

U

U

Milheiro 1994

40

0

20

20

N

U

U

Mimica 2000

100

0

50

50

U

U

U

Ortega 1996

20

0

10

10

N

U

U

Prisco 2000

25

5

10

10

Y

U

U

Putensen‐Himmer 1992

20

0

10

10

U

U

U

Rovina 1996

51

0

26

25

U

U

SS

Trondsen 1993

72

2

35

35

U

U

U

Volpino 1998

120

2

58

60

U

U

U

Zajac 1998

110

0

58

52

U

U

U

Zulfikaroglu 2002

50

0

25

25

U

U

U

total

2427

74

1165

1173

* three‐arm trial, patients in the SIC group not listed in this table.

N = no

Y = yes

U = unknown

S = one surgeon

SS = a few surgeons

R = also registrars

Figuras y tablas -
Table 1. Randomised, excluded, and included in LC versus OC
Table 2. Description of background data (age, gender, 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 OC

randomised

LC

OC

LC

OC

LC

OC

LC

OC

Agnifili 1993

29 / 21

46.7 (4.5)

48.2 (3.4)

12 / 19

9 / 10

21 ‐ 7 ‐ 3 ‐ 0

15 ‐ 3 ‐ 1 ‐ 0

Bablekos 2003

18 / 10

52.6 (12.2)

54.8 (9.2)

Bellon 1998

14 / 14

42 ( ‐ )

47 ( ‐ )

7 / 7

6 / 8

Berggren 1994

15 / 12

41.4 (12.9)

42.8 (13.7)

5 / 10

4 / 8

Blanc‐Louvry 2000

25 / 16

63 (5)#

55 (4)#

12 / 13

7 / 9

13 ‐ 12 ‐ 0 ‐ 0

9 ‐ 7 ‐ 0 ‐ 0

Bukan 2004

15 / 15

50 (38‐65)

48 (41‐62)

6 / 9

5 / 10

Charlo 1995

100 / 100

49 (16)

49 (16)

22 / 78

25 / 75

Chaudhary 1999

21 / 22

36.1 (8.7)

37.6 (9.7)

1 / 19

1 / 19

22.4 (1.4)

23.0 (1.1)

20 ‐ 0 ‐ 0 ‐ 0

20 ‐ 0 ‐ 0 ‐ 0

Chumillas 1998

20 / 20

60.7 (12.6)

63.3 (10)

4 / 16

5 / 15

26.5 (4.5)

27.1 (4.9)

Coelho 1993

15 / 15

42.7 (25‐70)

45.4 (18‐73)

3 / 12

3 / 12

Coskun 2000

35 / 35

46.7 (40‐54)

46.4 (40‐55)

5 / 30

6 / 29

Dauleh 1995

40 / 38

47.7 (18‐75)

50.8 (20‐88)

8 / 30

10 / 28

Demirer 2000

50 / 50

46* (31‐70)

48* (20‐66)

14 / 36

18 / 32

50 ‐ 0 ‐ 0 ‐ 0

50 ‐ 0 ‐ 0 ‐ 0

Dionigi 1994

30 / 27

39 (11)

46 (14)

7 / 23

9 / 18

Engin 1998

16 / 16

Essen 1995

6 / 6

38 (3)#

38 (6)#

2 / 4

2 / 4

Gal 1997

21 / 21

Galizia 2001

10 / 5

37.4 (2.2)#

36.8 (2.7)#

8 / 2

3 / 2

24.8 (1.0)

25.5 (0.5)

10 ‐ 0 ‐ 0 ‐ 0

5 ‐ 0 ‐ 0 ‐ 0

Garcia‐Caballero 1993

20 / 76

Hasukic 2002

30 / 28

46.9 (2.3)

49.2 (12.9)

7 / 23

5 / 23

Hendolin 2000

25 / 22

49 (12)

53 (12)

7 / 18

7 / 15

27 (8)

28 (8)

16 ‐ 8 ‐ 1 ‐ 0

7 ‐ 11 ‐ 2 ‐ 0

Huang 1996

15 / 12

nd

nd

nd

nd

Jan 1993

50 / 51

49.5 (11.3)

50.3 (13.1)

18 / 32

20 / 31

Karayiannakis 1997

45 / 42

57 (12)

58 (10)

18 / 23

18 / 24

Kjaersgaard 1994

35 / 35

43 (19‐80)

53 (19‐79)

5 / 30

5 / 30

Koprulu 1996

20 / 20

47 (6)

42 (9)

6 / 14

8 / 12

Lausten 1999 (1)

7 / 7

48 (3)

48.6 (4)

4 / 3

3 / 4

Lausten 1999 (2)

7 / 7

40.7 (2.8)

46.1 (5.8)

2 / 5

4 / 3

Lujan 1998

133 / 131

71 (65‐87)

72 (65‐87)

42 / 91

38 / 93

Luo 2003

14 / 12

46.6* (15.8)#

45.5* (12.6)#

6 / 8

3 / 9

Milheiro 1994

20 / 20

51 (16)

62 (18)

5 / 15

7 / 13

13 ‐ 5 ‐ 2 ‐ 0

13 ‐ 5 ‐ 2 ‐ 0

Mimica 2000

50 / 50

nd

nd

50 ‐ 0 ‐ 0 ‐ 0

50 ‐ 0 ‐ 0 ‐ 0

Ortega 1996

10 / 10

34 (2)

33 (3)

0 / 10

0 / 10

10 ‐ 0 ‐ 0 ‐ 0

10 ‐ 0 ‐ 0 ‐ 0

Prisco 2000

10 / 10

55 (12.5)

58.3 (9.3)

4 / 6

6 / 4

27.3 (5.2)

28.9 (4.5)

Putensen‐Himmer 1992

10 / 10

41.2 (10.7)

41.5 (13.5)

3 / 7

2 / 8

10 ‐ 0 ‐ 0 ‐ 0

10 ‐ 0 ‐ 0 ‐ 0

Rovina 1996

26 / 25

49 (12)

50 (15)

4 / 22

6 / 19

Schauer 1993

20 / 20

37.2 (17‐63)

38.5 (13‐64)

2 / 18

4 / 16

32.2

30.3

Trondsen 1993

35 / 35

43* (19‐80)

55* (19‐78)

30 / 5

30 / 5

Volpino 1998

58 / 60

47.7 (17.1)

53.5 (16.0)

16 / 42

20 / 40

44 ‐ 14 ‐ 0

45 ‐ 15 ‐ 0

Zajac 1998

58 / 52

76.7 (2.2)

75.9 (2.1)

nd

nd

0 ‐ 19 ‐ 39 ‐ 0

0 ‐ 28 ‐ 24 ‐ 0

Zulfikaroglu 2002

25 / 25

45.8 (11)

52.9 (12.1)

2 / 23

3 / 22

25 ‐ 0 ‐ 0

25 ‐ 0 ‐ 0

* median

# standard error of mean

nd: 'no difference' reported

Figuras y tablas -
Table 2. Description of background data (age, gender, BMI and ASA)
Table 3. Complications specified per operative technique: LC versus OC

Complications

LC

OC

INTRA‐OPERATIVE

(10 / 0.9%)

(1 / 0.1%)

gallbladder perforation

7

1

bleeding

2

0

other (not specified)

1

0

POSTOPERATIVE ‐ MINOR

(25 / 2.1%)

(36 / 3.1%)

retained bile duct stone (ERCP)

1

2

wound infection

3

17

wound hematoma

3

0

urinary tract infection

7

7

flebitis

3

4

readmission (abdominal pain)

2

0

other (unspecified)

6

6

POSTOPERATIVE ‐ SEVERE

(26 / 2.2%)

(80 / 6.8%)

bleeding: drainage/blood transfusion

4

1

bleeding: re‐operation

2

0

ileus: conservative

4

9

platzbauch

0

3

abscess (drainage / unspecified)

1

2

biliary fistula (unspecified / conservative)

1

1

pneumonia

6

18

respiratory insufficiency / atelectasis

6

35

septic shock (multi organ failure)

0

1

cardiovascular

0

5

Cerebrovascular accident

0

1

upper GI bleeding (endoscopy / conservative)

0

3

other (unspecified)

2

1

BILE DUCT INJURY

(2 / 0.2%)

(2 / 0.2%)

cystic duct leakage: drainage/ERCP

0

1

bile leakage (origin unknown): conservative

2

1

TOTAL COMPLICATIONS

63 (5.4%)

119 (10.1%)

RE‐OPERATIONS (all complications)

3 (0.3%)

3 (0.3%)

TOTAL NUMBER OF PATIENTS INCLUDED (all trials)

1165

1173

Figuras y tablas -
Table 3. Complications specified per operative technique: LC versus OC
Table 4. Internal validity assessment of included trials: LC vs OC

Trial

Generation of allocation sequence

Concealment of allocation

Blinding

Follow‐up

Agnifili 1993

U

U

N

U

Bellon 1998

U

U

N

U

Berggren 1994

U

A

N

U

Blanc‐Louvry 2000

A

U

N

U

Bukan 2004

U

U

N

U

Charlo 1995

A

U

N

U

Chaudhary 1999

A

U

A

A

Chumillas1998

U

A

N

U

Coelho 1993

U

U

N

U

Coskun 2000

U

U

N

U

Dauleh 1995

U

U

N

U

Demirer 2000

U

U

N

A

Dionigi 1994

U

U

N

U

Engin 1998

U

A

N

U

Essen 1995

U

A

N

U

Gal 1997

U

U

N

U

Galizia 2001

U

A

N

U

Garcia‐Caballero 1993

U

U

A

A

Hasukic 2002

U

U

N

U

Hendolin 2000

U

A

N

U

Huang 1996

U

U

N

U

Jan 1993

A

N

N

A

Karayiannakis1997

U

A

N

A

Kjaersgaard 1994

U

U

N

A

Koprulu 1996

U

U

N

U

Lausten 1999

U

U

N

U

Lujan 1998

U

U

N

U

Luo 2003

U

U

N

U

Milheiro 1994

U

A

N

U

Mimica 2000

U

A

N

U

Ortega 1996

A

U

A

U

Prisco 2000

U

U

N

U

Putensen‐Himmer 1992

U

U

N

U

Rovina 1996

U

U

N

U

Trondsen 1993

U

U

N

U

Volpino 1998

U

U

N

U

Zajac 1998

U

U

N

U

Zulfikaroglu 2002

U

U

N

U

A: Adequate

U: Unclear

I: Inadequate

N: Not performed

Figuras y tablas -
Table 4. Internal validity assessment of included trials: LC vs OC
Table 5. Results of LC versus OC: allocation concealment (comparison 2)

Outcome

RD/WMD

HQ/LQ/AT

Fixed

Random

Discrepancy

Emphasize

HQ‐LQ difference

Significant

severe complications

RD

HQ

‐0.01 (‐0.04, 0.03)

0.00 (‐0.03, 0.02)

no

LQ

‐0.06 (‐0.09, ‐0.04) *

‐0.04 (‐0.08, 0.00)

yes

AT

‐0.05 (‐0.07, ‐0.03) *

‐0.03 (‐0.06, 0.00)

yes

random

no

no

total complications

RD

HQ

‐0.02 (‐0.06, 0.02)

‐0.01 (‐0.05, 0.02)

no

LQ

‐0.07 (‐0.10, ‐0.04) *

‐0.05 (‐0.10, ‐0.01) *

no

AT

‐0.06 (‐0.08, ‐0.03) *

‐0.04 (‐0.07, ‐0.01) *

no

random

yes

no

operative time

WMD

HQ

‐0.74 (‐5.20, 3.71)

‐1.14 (‐12.80, 10.52)

no

LQ

7.45 (6.06, 8.84) *

5.72 (‐5.34, 16.77)

yes

AT

6.73 (5.40, 8.05) *

3.79 (‐4.88, 12.46)

yes

random

no

no

hospital stay

WMD

HQ

‐2.48 (‐2.73, ‐2.22) *

‐3.23 (‐4.75, ‐1.71) *

no

LQ

‐1.62 (‐1.71, ‐1.53) *

‐3.01 (‐3.97, ‐2.06) *

no

AT

‐1.72 (‐1.80, ‐1.63) *

‐3.07 (‐3.89, ‐2.26) *

no

random

no

yes

convalescence work leave

WMD

HQ

‐12.30 (‐15.54, ‐9.06) *

‐12.30 (‐15.54, ‐9.06) *

no

LQ

‐31.89 (‐32.58, ‐31.19) *

‐28.10 (‐36.75, ‐19.44) *

no

AT

‐31.01 (‐31.70, ‐30.33) *

‐22.51 (‐36.89, ‐8.13) *

no

random

no

yes

* significant result

HQ: high quality trials

LQ: low quality trials

AT: all trials

RD: risk difference

WMD: weighted mean difference

random: random‐effects method

Figuras y tablas -
Table 5. Results of LC versus OC: allocation concealment (comparison 2)
Table 6. Operative time LC versus OC: all available data

Trial

Type of data

LC ‐ mean/median

LC ‐ SD/range

OC ‐ mean/median

OC ‐ SD/range

Skewness LC

Skewness OC

Agnifili 1993

A ‐ SD

43.2

16

53.3

19.1

2.7

2.79

Bellon 1998

60 ‐ 80

60 ‐ 80

Berggren 1994

A ‐ SD

87.00

24.33

69.17

11.25

3.58

6.18

Blanc‐Louvry 2000

A ‐ SEM

61

4 (20*)

74

5 (20*)

3.05

3.7

Bukan 2004

A ‐ SD

55

15.4

73

24.3

3.57

3.00

Charlo 1995

Chaudhary 1999

Chumillas 1998

A ‐ SD

104

34.39

111.75

30.57

3.02

3.66

Coelho 1993

A ‐ range

107

55 ‐ 150

86

40 ‐ 140

Coskun 2000

A ‐ range

78.2

30 ‐ 130

99.7

71 ‐ 125

Dauleh 1995

A ‐ range

97.3

50 ‐ 150

48.2

20 ‐ 120

Demirer 2000

M ‐ range

40

25 ‐ 50

59

35 ‐ 75

Dionigi 1994

A ‐ SD

89

29

78

20

3.07

3.9

Engin 1998

A ‐ SD

82.4

26.64

79.5

31.23

3.09

2.55

Essen 1995

A ‐ SD

87

36

79

22

2.42

3.59

Gal 1997

Galizia 2001

A ‐ SEM

66 and 70

4.8 and 4.5 (14.7*)

60

1.6 (3.6*)

4.63

16.67

Garcia‐Caballero 1993

Hasukic 2002

A ‐ SD

77.83

12.01

71.48

8.26

6.48

8.65

Hendolin 2000

A ‐ range

90

45 ‐ 160

90

60 ‐ 150

Huang 1996

A ‐ SD

93.3

25.3

176.3

26.1

3.69

6.75

Jan 1993

A ‐ SD

85.7

25.2

48

13.9

3.40

3.45

Karayiannakis 1997

A ‐ SD

105

25

98

17

4.2

5.76

Kjaersgaard 1994

A ‐ range

103

93 ‐ 112

53

46 ‐ 61

Koprulu 1996

Lausten 1999 (1)

A ‐ SD

121

14

129

23

8.64

5.61

Lausten 1999 (2)

A ‐ SD

112

12

90

7

9.33

12.86

Lujan 1998

A ‐ range

75

20 ‐ 180

70.9

49 ‐ 115

Luo 2003

M ‐ SEM

50.9

8.9 (33.3*)

58.5

6.3 (21.8*)

1.53

2.68

Milheiro 1994

A ‐ SD

60

21

88

15

2.86

5.87

Mimica 2000

A ‐ SD

102

20

110

32

5.1

3.44

Ortega 1996

A ‐ SD

70

6

77

6.3

11.67

12.22

Prisco 2000

A ‐ SD

115

22

105

19

5.23

5.53

Putensen‐Himmer 1992

A ‐ SD

104

25

112

37

4.16

3.03

Rovina 1996

A ‐ SD

155

27

46

13

5.74

3.54

Trondsen 1993

M ‐ range

100

52 ‐ 180

50

15 ‐ 115

Volpino 1998

A ‐ SD

86.6

22

81

24.79

3.94

3.27

Zajac 1998

A ‐ SD

54

5

47

4

10.8

11.75

Zulfikaroglu 2002

A ‐ SD

69.2

17.2

66.8

16.8

4.02

3.98

* SD calculated from SEM (handbook page 89)

A: Average / mean

M: Median

SD: standard deviation

SEM: standard error of mean

Figuras y tablas -
Table 6. Operative time LC versus OC: all available data
Table 7. Hospital stay LC versus OC: all available data

Trial

Type of data

LC ‐ mean/median

LC ‐ SD/range

OC ‐ mean/median

OC ‐ SD/range

Skewness LC

Skewness OC

Agnifili 1993

A ‐ SD

3.2

1.2

7.3

3.2

2.67

2.28

Bellon 1998

A ‐

2.3

6.2

Berggren 1994

A ‐ SD

1.8

0.56

2.83

0.84

3.21

3.33

Blanc‐Louvry 2000

A ‐ SEM

2.5

0.2 (1.0*)

4.6

0.3 (1.2*)

2.5

3.83

Bukan 2004

A ‐ SD

2

0.2

5

0.4

10

12.5

Charlo 1995

A ‐ SD

3

1.01

7

2.63

2.97

2.66

Chaudhary 1999

Chumillas 1998

A ‐ SD

3.25

0.71

10.57

4.67

4.58

2.26

Coelho 1993

A ‐ range

1

0

2

2‐3

Coskun 2000

Dauleh 1995

A ‐ range

3.4

2 ‐ 5

6.5

3 ‐ 15

Demirer 2000

M ‐ range

2

1 ‐ 3

7

5 ‐ 15

Dionigi 1994

A ‐ SD

3.1

0.5

7.1

1.6

6.2

4.44

Engin 1998

A ‐ SD

1.68

0.60

3.06

0.77

2.8

3.97

Essen 1995

A ‐ SD

1.3

0.5

2.5

0.6

2.6

4.17

Gal 1997

Galizia 2001

A ‐ SD

1

0.01

5.2

2.2

100

2.36

Garcia‐Caballero 1993

Hasukic 2002

Hendolin 2000

A ‐ range

2

1 ‐ 15

4

2 ‐ 19

Huang 1996

A ‐ SD

3.93

1.71

7.92

0.79

2.29

9.88

Jan 1993

A ‐ SD

4.5

1.4

5.6

1.3

3.21

4.31

Karayiannakis 1997

A ‐ SD

2

0.6

5.6

1.1

3.33

5.09

Kjaersgaard 1994

A ‐ CI

2.5

2.0 ‐ 3.1 (1.61*)

4.9

3.4 ‐ 6.3 (4.25*)

1.55

1.15

Koprulu 1996

Lausten 1999 (1)

A ‐ SD

2.9

0.3

5.3

0.3

9.67

17.67

Lausten 1999 (2)

A ‐ SD

2.7

0.3

4.6

0.2

9

23

Lujan 1998

A ‐ range

3.71

1 ‐ 27

9.9

5 ‐ 33

Luo 2003

A ‐ SEM

3.2

0.3 (1.12*)

6.7

0.2 (0.69*)

2.86

9.71

Milheiro 1994

Mimica 2000

Ortega 1996

A ‐ SD

1.2

0.2

1.1

0.1

6

11

Prisco 2000

A ‐ SD

2

0.01

5.6

0.52

200

10.77

Putensen‐Himmer 1992

Rovina 1996

Trondsen 1993

M ‐ range

2

1 ‐ 9

4

2 ‐ 22

Volpino 1998

A ‐ SD

4.6

2.9

7.77

3.1

1.59

2.51

Zajac 1998

A ‐ SD

1

0.01

9.1

2.8

100

3.25

Zulfikaroglu 2002

* SD calculated from SEM / CI

A: Average / mean

M: Median

SD: standard deviation

SEM: standard error of mean

Figuras y tablas -
Table 7. Hospital stay LC versus OC: all available data
Comparison 1. LC versus OC ‐ 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

15

987

Risk Difference (M‐H, Fixed, 95% CI)

‐0.00 [‐0.02, 0.01]

1.1 High‐quality trial

2

301

Risk Difference (M‐H, Fixed, 95% CI)

0.0 [‐0.02, 0.02]

1.2 Low‐quality trial

13

686

Risk Difference (M‐H, Fixed, 95% CI)

‐0.00 [‐0.02, 0.02]

2 Intra‐operative complications Show forest plot

30

1914

Risk Difference (M‐H, Fixed, 95% CI)

0.01 [‐0.00, 0.02]

2.1 High‐quality trial

4

364

Risk Difference (M‐H, Fixed, 95% CI)

0.01 [‐0.02, 0.03]

2.2 Low‐quality trial

26

1550

Risk Difference (M‐H, Fixed, 95% CI)

0.01 [‐0.01, 0.02]

3 Minor complications Show forest plot

30

1914

Risk Difference (M‐H, Fixed, 95% CI)

‐0.01 [‐0.03, 0.00]

3.1 High‐quality trial

4

364

Risk Difference (M‐H, Fixed, 95% CI)

‐0.01 [‐0.04, 0.03]

3.2 Low‐quality trial

26

1550

Risk Difference (M‐H, Fixed, 95% CI)

‐0.02 [‐0.04, 0.01]

4 Severe complications (without bile duct injuries) Show forest plot

30

1914

Risk Difference (M‐H, Random, 95% CI)

‐0.03 [‐0.06, 0.00]

4.1 High‐quality trial

4

364

Risk Difference (M‐H, Random, 95% CI)

‐0.00 [‐0.06, 0.05]

4.2 Low‐quality trial

26

1550

Risk Difference (M‐H, Random, 95% CI)

‐0.03 [‐0.07, 0.00]

5 Bile duct injuries Show forest plot

30

1914

Risk Difference (M‐H, Fixed, 95% CI)

‐0.00 [‐0.01, 0.01]

5.1 High‐quality trial

4

364

Risk Difference (M‐H, Fixed, 95% CI)

0.01 [‐0.02, 0.03]

5.2 Low‐quality trial

26

1550

Risk Difference (M‐H, Fixed, 95% CI)

‐0.00 [‐0.01, 0.01]

6 Total complications Show forest plot

30

1914

Risk Difference (M‐H, Random, 95% CI)

‐0.04 [‐0.07, ‐0.01]

6.1 High‐quality trial

4

364

Risk Difference (M‐H, Random, 95% CI)

‐0.00 [‐0.08, 0.08]

6.2 Low‐quality trial

26

1550

Risk Difference (M‐H, Random, 95% CI)

‐0.05 [‐0.09, ‐0.01]

7 Operative time (minutes) Show forest plot

24

1134

Mean Difference (IV, Random, 95% CI)

3.79 [‐4.88, 12.46]

7.1 High‐quality trial

3

162

Mean Difference (IV, Random, 95% CI)

6.04 [‐25.72, 37.81]

7.2 Low‐quality trial

21

972

Mean Difference (IV, Random, 95% CI)

3.37 [‐6.29, 13.04]

8 Hospital stay (days) Show forest plot

21

1111

Mean Difference (IV, Random, 95% CI)

‐3.07 [‐3.89, ‐2.26]

8.1 High‐quality trial

4

362

Mean Difference (IV, Random, 95% CI)

‐1.76 [‐3.70, 0.17]

8.2 Low‐quality trial

17

749

Mean Difference (IV, Random, 95% CI)

‐3.34 [‐3.97, ‐2.71]

9 Convalescence: work leave (days) Show forest plot

3

328

Mean Difference (IV, Random, 95% CI)

‐22.51 [‐36.89, ‐8.13]

9.1 High‐quality trial

2

301

Mean Difference (IV, Random, 95% CI)

‐28.10 [‐36.75, ‐19.44]

9.2 Low‐quality trial

1

27

Mean Difference (IV, Random, 95% CI)

‐12.3 [‐15.54, ‐9.06]

Figuras y tablas -
Comparison 1. LC versus OC ‐ high‐quality and low‐quality trials regarding generation of the allocation sequence
Comparison 2. LC versus OC ‐ high‐quality and low‐quality trials regarding concealment of allocation

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mortality Show forest plot

15

987

Risk Difference (M‐H, Fixed, 95% CI)

‐0.00 [‐0.02, 0.01]

1.1 High‐quality trials

6

254

Risk Difference (M‐H, Fixed, 95% CI)

0.0 [‐0.04, 0.04]

1.2 Low‐quality trials

9

733

Risk Difference (M‐H, Fixed, 95% CI)

‐0.00 [‐0.02, 0.01]

2 Intra‐operative complications Show forest plot

30

1914

Risk Difference (M‐H, Fixed, 95% CI)

0.01 [‐0.00, 0.02]

2.1 High‐quality trials

8

388

Risk Difference (M‐H, Fixed, 95% CI)

0.01 [‐0.02, 0.04]

2.2 Low‐quality trials

22

1526

Risk Difference (M‐H, Fixed, 95% CI)

0.01 [‐0.01, 0.02]

3 Minor complications Show forest plot

30

1914

Risk Difference (M‐H, Fixed, 95% CI)

‐0.01 [‐0.03, 0.00]

3.1 High‐quality trials

8

388

Risk Difference (M‐H, Fixed, 95% CI)

‐0.02 [‐0.06, 0.02]

3.2 Low‐quality trials

22

1526

Risk Difference (M‐H, Fixed, 95% CI)

‐0.01 [‐0.03, 0.01]

4 Severe complications (without bile duct injuries) Show forest plot

30

1914

Risk Difference (M‐H, Random, 95% CI)

‐0.03 [‐0.06, 0.00]

4.1 High‐quality trials

8

388

Risk Difference (M‐H, Random, 95% CI)

‐0.00 [‐0.03, 0.02]

4.2 Low‐quality trials

22

1526

Risk Difference (M‐H, Random, 95% CI)

‐0.04 [‐0.08, ‐0.00]

5 Bile duct injuries Show forest plot

30

1914

Risk Difference (M‐H, Fixed, 95% CI)

‐0.00 [‐0.01, 0.01]

5.1 High‐quality trials

8

388

Risk Difference (M‐H, Fixed, 95% CI)

0.0 [‐0.03, 0.03]

5.2 Low‐quality trials

22

1526

Risk Difference (M‐H, Fixed, 95% CI)

‐0.00 [‐0.01, 0.01]

6 Total complications Show forest plot

30

1914

Risk Difference (M‐H, Random, 95% CI)

‐0.04 [‐0.07, ‐0.01]

6.1 High‐quality trials

8

388

Risk Difference (M‐H, Random, 95% CI)

‐0.01 [‐0.05, 0.02]

6.2 Low‐quality trials

22

1526

Risk Difference (M‐H, Random, 95% CI)

‐0.05 [‐0.10, ‐0.01]

7 Operative time (minutes) Show forest plot

24

1134

Mean Difference (IV, Random, 95% CI)

3.79 [‐4.88, 12.46]

7.1 High‐quality trials

7

341

Mean Difference (IV, Random, 95% CI)

‐1.14 [‐12.80, 10.52]

7.2 Low‐quality trials

17

793

Mean Difference (IV, Random, 95% CI)

5.72 [‐5.34, 16.77]

8 Hospital stay (days) Show forest plot

21

1111

Mean Difference (IV, Random, 95% CI)

‐3.07 [‐3.89, ‐2.26]

8.1 High‐quality trials

5

201

Mean Difference (IV, Random, 95% CI)

‐3.23 [‐4.75, ‐1.71]

8.2 Low‐quality trials

16

910

Mean Difference (IV, Random, 95% CI)

‐3.01 [‐3.97, ‐2.06]

9 Convalescence: work leave (days) Show forest plot

3

328

Mean Difference (IV, Random, 95% CI)

‐22.51 [‐36.89, ‐8.13]

9.1 High‐quality trials

1

27

Mean Difference (IV, Random, 95% CI)

‐12.3 [‐15.54, ‐9.06]

9.2 Low‐quality trials

2

301

Mean Difference (IV, Random, 95% CI)

‐28.10 [‐36.75, ‐19.44]

Figuras y tablas -
Comparison 2. LC versus OC ‐ high‐quality and low‐quality trials regarding concealment of allocation
Comparison 3. LC versus OC ‐ 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

15

987

Risk Difference (M‐H, Fixed, 95% CI)

‐0.00 [‐0.02, 0.01]

1.1 High‐quality trials

0

0

Risk Difference (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.2 Low‐quality trials

15

987

Risk Difference (M‐H, Fixed, 95% CI)

‐0.00 [‐0.02, 0.01]

2 Intra‐operative complications Show forest plot

30

1914

Risk Difference (M‐H, Fixed, 95% CI)

0.01 [‐0.00, 0.02]

2.1 High‐quality trials

2

63

Risk Difference (M‐H, Fixed, 95% CI)

0.0 [‐0.09, 0.09]

2.2 Low‐quality trials

28

1851

Risk Difference (M‐H, Fixed, 95% CI)

0.01 [‐0.00, 0.02]

3 Minor complications Show forest plot

30

1914

Risk Difference (M‐H, Fixed, 95% CI)

‐0.01 [‐0.03, 0.00]

3.1 High‐quality trials

2

63

Risk Difference (M‐H, Fixed, 95% CI)

‐0.03 [‐0.14, 0.07]

3.2 Low‐quality trials

28

1851

Risk Difference (M‐H, Fixed, 95% CI)

‐0.01 [‐0.03, 0.01]

4 Severe complications (without bile duct injuries) Show forest plot

30

1914

Risk Difference (M‐H, Random, 95% CI)

‐0.03 [‐0.06, 0.00]

4.1 High‐quality trials

2

63

Risk Difference (M‐H, Random, 95% CI)

‐0.03 [‐0.13, 0.07]

4.2 Low‐quality trials

28

1851

Risk Difference (M‐H, Random, 95% CI)

‐0.03 [‐0.06, 0.00]

5 Bile duct injuries Show forest plot

30

1914

Risk Difference (M‐H, Fixed, 95% CI)

‐0.00 [‐0.01, 0.01]

5.1 High‐quality trials

2

63

Risk Difference (M‐H, Fixed, 95% CI)

0.0 [‐0.09, 0.09]

5.2 Low‐quality trials

28

1851

Risk Difference (M‐H, Fixed, 95% CI)

‐0.00 [‐0.01, 0.01]

6 Total complications Show forest plot

30

1914

Risk Difference (M‐H, Random, 95% CI)

‐0.04 [‐0.07, ‐0.01]

6.1 High‐quality trials

2

63

Risk Difference (M‐H, Random, 95% CI)

‐0.05 [‐0.16, 0.06]

6.2 Low‐quality trials

28

1851

Risk Difference (M‐H, Random, 95% CI)

‐0.04 [‐0.07, ‐0.01]

7 Operative time (minutes) Show forest plot

24

1134

Mean Difference (IV, Random, 95% CI)

3.79 [‐4.88, 12.46]

7.1 High‐quality trials

1

20

Mean Difference (IV, Random, 95% CI)

‐7.0 [‐12.39, ‐1.61]

7.2 Low‐quality trials

23

1114

Mean Difference (IV, Random, 95% CI)

4.25 [‐5.03, 13.53]

8 Hospital stay (days) Show forest plot

21

1111

Mean Difference (IV, Random, 95% CI)

‐3.07 [‐3.89, ‐2.26]

8.1 High‐quality trials

1

20

Mean Difference (IV, Random, 95% CI)

0.10 [‐0.04, 0.24]

8.2 Low‐quality trials

20

1091

Mean Difference (IV, Random, 95% CI)

‐3.19 [‐3.77, ‐2.61]

9 Convalescence: work leave (days) Show forest plot

3

328

Mean Difference (IV, Random, 95% CI)

‐22.51 [‐36.89, ‐8.13]

9.1 High‐quality trials

0

0

Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

9.2 Low‐quality trials

3

328

Mean Difference (IV, Random, 95% CI)

‐22.51 [‐36.89, ‐8.13]

Figuras y tablas -
Comparison 3. LC versus OC ‐ high‐quality and low‐quality trials regarding blinding
Comparison 4. LC versus OC ‐ 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

15

947

Risk Difference (M‐H, Fixed, 95% CI)

‐0.00 [‐0.02, 0.01]

1.1 High‐quality trials

1

101

Risk Difference (M‐H, Fixed, 95% CI)

0.0 [‐0.04, 0.04]

1.2 Low‐quality trials

14

846

Risk Difference (M‐H, Fixed, 95% CI)

‐0.00 [‐0.02, 0.02]

2 Intra‐operative complications Show forest plot

30

1914

Risk Difference (M‐H, Fixed, 95% CI)

0.01 [‐0.00, 0.02]

2.1 High‐quality trials

4

331

Risk Difference (M‐H, Fixed, 95% CI)

0.01 [‐0.02, 0.03]

2.2 Low‐quality trials

26

1583

Risk Difference (M‐H, Fixed, 95% CI)

0.01 [‐0.01, 0.02]

3 Minor complications Show forest plot

30

1914

Risk Difference (M‐H, Fixed, 95% CI)

‐0.01 [‐0.03, 0.00]

3.1 High‐quality trials

4

331

Risk Difference (M‐H, Fixed, 95% CI)

‐0.01 [‐0.03, 0.02]

3.2 Low‐quality trials

26

1583

Risk Difference (M‐H, Fixed, 95% CI)

‐0.01 [‐0.04, 0.01]

4 Severe complications (without bile duct injuries) Show forest plot

30

1914

Risk Difference (M‐H, Random, 95% CI)

‐0.03 [‐0.06, 0.00]

4.1 High‐quality trials

4

331

Risk Difference (M‐H, Random, 95% CI)

0.00 [‐0.02, 0.03]

4.2 Low‐quality trials

26

1583

Risk Difference (M‐H, Random, 95% CI)

‐0.04 [‐0.07, ‐0.00]

5 Bile duct injuries Show forest plot

30

1914

Risk Difference (M‐H, Fixed, 95% CI)

‐0.00 [‐0.01, 0.01]

5.1 High‐quality trials

4

331

Risk Difference (M‐H, Fixed, 95% CI)

0.0 [‐0.02, 0.02]

5.2 Low‐quality trials

26

1583

Risk Difference (M‐H, Fixed, 95% CI)

‐0.00 [‐0.01, 0.01]

6 Total complications Show forest plot

30

1914

Risk Difference (M‐H, Random, 95% CI)

‐0.04 [‐0.07, ‐0.01]

6.1 High‐quality trials

4

331

Risk Difference (M‐H, Random, 95% CI)

0.01 [‐0.03, 0.05]

6.2 Low‐quality trials

26

1583

Risk Difference (M‐H, Random, 95% CI)

‐0.05 [‐0.09, ‐0.02]

7 Operative time (minutes) Show forest plot

24

1134

Mean Difference (IV, Random, 95% CI)

3.79 [‐4.88, 12.46]

7.1 High‐quality trials

2

188

Mean Difference (IV, Random, 95% CI)

22.42 [‐7.67, 52.50]

7.2 Low‐quality trials

22

946

Mean Difference (IV, Random, 95% CI)

1.94 [‐7.19, 11.07]

8 Hospital stay (days) Show forest plot

21

1111

Mean Difference (IV, Random, 95% CI)

‐3.07 [‐3.89, ‐2.26]

8.1 High‐quality trials

3

258

Mean Difference (IV, Random, 95% CI)

‐2.37 [‐4.29, ‐0.45]

8.2 Low‐quality trials

18

853

Mean Difference (IV, Random, 95% CI)

‐3.19 [‐4.09, ‐2.29]

9 Convalescence: work leave (days) Show forest plot

3

328

Mean Difference (IV, Random, 95% CI)

‐22.51 [‐36.89, ‐8.13]

9.1 High‐quality trials

1

101

Mean Difference (IV, Random, 95% CI)

‐23.10 [‐29.26, ‐16.94]

9.2 Low‐quality trials

2

227

Mean Difference (IV, Random, 95% CI)

‐22.22 [‐41.52, ‐2.91]

Figuras y tablas -
Comparison 4. LC versus OC ‐ high‐quality and low‐quality trials regarding follow‐up
Comparison 5. LC versus OC ‐ 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 non‐reporting trials Show forest plot

39

2338

Risk Difference (M‐H, Fixed, 95% CI)

‐0.00 [‐0.01, 0.01]

2 Sensitivity analysis 2: Imputing medians and standard deviations for missing data in operative time (minutes) Show forest plot

33

1889

Mean Difference (IV, Random, 95% CI)

6.42 [‐1.21, 14.04]

3 Sensitivity analysis 3: Imputing medians and standard deviations for missing data in hospital stay (days) Show forest plot

28

1728

Mean Difference (IV, Random, 95% CI)

‐3.15 [‐3.94, ‐2.35]

4 Subgroup analysis 1: Influence antibiotic prophylaxis on total complications Show forest plot

30

1914

Risk Difference (M‐H, Random, 95% CI)

‐0.04 [‐0.08, ‐0.01]

4.1 Antibiotic: yes

3

349

Risk Difference (M‐H, Random, 95% CI)

‐0.06 [‐0.14, 0.03]

4.2 Antibiotic: no / unknown

27

1565

Risk Difference (M‐H, Random, 95% CI)

‐0.04 [‐0.08, ‐0.01]

5 Subgroup analysis 2: Influence cholangiography on operative time (minutes) Show forest plot

14

746

Mean Difference (IV, Random, 95% CI)

‐2.02 [‐9.36, 5.33]

5.1 Cholangiography: yes

5

387

Mean Difference (IV, Random, 95% CI)

‐1.95 [‐11.40, 7.51]

5.2 Cholangiography: no

9

359

Mean Difference (IV, Random, 95% CI)

‐2.16 [‐12.89, 8.58]

6 Subgroup analysis 3: Influence antibiotic prophylaxis on hospital stay (days) Show forest plot

28

1728

Mean Difference (IV, Random, 95% CI)

‐3.15 [‐3.94, ‐2.35]

6.1 Antibiotic prophylaxis: yes

1

264

Mean Difference (IV, Random, 95% CI)

‐6.19 [‐6.49, ‐5.89]

6.2 Antibiotic prophylaxis: no / unknown

27

1464

Mean Difference (IV, Random, 95% CI)

‐3.02 [‐3.73, ‐2.31]

Figuras y tablas -
Comparison 5. LC versus OC ‐ sensitivity and subgroup analyses