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Surgical Endoscopy
Published in: Surgical Endoscopy 2/2017

01-02-2017

Laparoscopic versus open cholecystectomy in pregnancy: a systematic review and meta-analysis

Authors: Negin Sedaghat, Amy M. Cao, Guy D. Eslick, Michael R. Cox

Published in: Surgical Endoscopy | Issue 2/2017

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Abstract

Background

The operative management of symptomatic cholelithiasis during pregnancy is either laparoscopic cholecystectomy (LC) or open cholecystectomy (OC). The aim of this systematic review and meta-analysis is to compare the outcomes of the laparoscopic and open approach for cholecystectomy during pregnancy.

Method

A literature search was conducted using MEDLINE, PubMed, EMBASE, Cochrane Library, Web of Science, CINAHL and Current Contents Connect using appropriate search terms. All comparative studies reporting maternal, fetal, and/or surgical complications were included.

Results

Eleven comparative studies, with a total of 10,632 patients, were included. The laparoscopic approach was performed at mean 18-week gestation and the open approach at mean 24-week gestation. LC was associated with decreased risks for fetal (OR 0.42; 95 % CI 0.28–0.63; p < 0.001), maternal (OR 0.42; 95 % CI 0.33–0.53; p < 0.001) and surgical (OR 0.45; 95 % CI 0.25–0.82, p = 0.01) complications. The average length of hospital stay (LOS) was: LC 3.2 days and OC 6.0 days (p = 0.02). The conversion rate from LC to OC was 3.8 %.

Conclusion

The results of this first meta-analysis suggest that LC is associated with fewer maternal and fetal complications than OC during pregnancy. However, 91 % of included patients were in the first or second trimester at the time of surgery. These findings do not account for gestational age during pregnancy, which may be a significant confounding factor. The results support intervention for symptomatic gallstones in the first and second trimester with a laparoscopic approach.
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Metadata
Title
Laparoscopic versus open cholecystectomy in pregnancy: a systematic review and meta-analysis
Authors
Negin Sedaghat
Amy M. Cao
Guy D. Eslick
Michael R. Cox
Publication date
01-02-2017
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 2/2017
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-016-5019-2

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