TRANSVAGINAL CHOLECYSTECTOMY COMPARED TO TRADITIONAL LAPAROSCOPIC CHOLECYSTECTOMY: A COMPREHENSIVE SYSTEMATIC REVIEW AND META-ANALYSIS: GS083P/ Трансвагінальна холецистектомія

TRANSVAGINAL CHOLECYSTECTOMY COMPARED TO TRADITIONAL LAPAROSCOPIC CHOLECYSTECTOMY: A COMPREHENSIVE SYSTEMATIC REVIEW AND META-ANALYSISGS083P

Gaik Si Quah; Guy Eslick

ANZ Journal of Surgery. 86():65, MAY 2016

Issn Print: 1445-1433

Publication Date: 2016/05/01

 

Excerpt

Purpose: Transvaginal cholecystectomy is one of the newest methods of performing cholecystectomy and its efficacy and safety has been controversial. The aim of this systemic review and meta-analysis was to review the available data comparing the safety and outcomes of transvaginal cholecystectomy (TVC) to the gold standard approach of laparoscopic cholecystectomy (LC).
Methodology: A comprehensive search of the online databases identified three prospective randomized studies and thirteen case- controlled studies or cohort studies that contained sufficient data on TVC. Data were extracted and pooled for analysis. We calculated pooled odds ratios (ORs) and 95 % confidence intervals using a random-effects model.
Results: The TVC group showed fewer overall complications (OR = 0.61, 95 % CI = 0.38 – 0.96, P = 0.03), post-operative complications (OR = 0.52, 95 % CI = 0.28 – 0.96, P = 0.04) including wound infections (OR = 0.29, 95 % CI = 0.09 – 0.99, P = 0.05) and reduced pain on day 1 – post-operative (p = 0.05). There was increased operative time in the TVC group (68.8 minutes vs 52.3 minutes, p = 0.03). There was no difference in rate of conversions, reoperations, biliary or hepatic injuries, time of return to normal activities or pain on day 3 post-operative.
Conclusions: This meta-analysis of the current published data establishes the safety of TVC when performed by experienced surgeons and is associated with reduced overall complications and wound infections.

 

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