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©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
Laparoscopic vs open radical resection in management of gallbladder carcinoma: A systematic review and meta-analysis
Shilin He, Tu-Nan Yu, Jia-Sheng Cao, Xue-Yin Zhou, Zhe-Han Chen, Wen-Bin Jiang, Liu-Xin Cai, Xiao Liang
Shilin He, Tu-Nan Yu, Jia-Sheng Cao, Xue-Yin Zhou, Wen-Bin Jiang, Liu-Xin Cai, Xiao Liang, Department of General Surgery, Sir Run-Run Shaw Hospital of Zhejiang University School of Medicine, Hangzhou 310016, Zhejiang Province, China
Xue-Yin Zhou, School of Medicine, Wenzhou Medical University, Wenzhou 325035, Zhejiang Province, China
Zhe-Han Chen, The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China
Zhe-Han Chen, Department of Hepatobiliary Surgery, Fuyang First People’s Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou 311400, Zhejiang Province, China
Author contributions: He S acquired, analyzed, and interpreted the data, drafted the manuscript, and approved the final manuscript; Yu TN, Cao JS, and Cai LX revised the manuscript and approved the final manuscript; Zhou XY and Chen ZH interpreted the data, revised the manuscript, and approved the final manuscript; Jiang WB acquired and interpreted the data, and approved the final manuscript; Liang X conceptualized and designed the study, critically revised the manuscript, and approved the final manuscript.
Conflict-of-interest statement: The authors deny any conflict of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Xiao Liang, MD, PhD, Attending Doctor, Professor, Surgeon, Department of General Surgery, Sir Run-Run Shaw Hospital of Zhejiang University School of Medicine, No. 3 East Qingchun Road, Hangzhou 310016, Zhejiang Province, China. srrshlx@zju.edu.cn
Received: May 20, 2023
Peer-review started: May 20, 2023
First decision: June 15, 2023
Revised: June 29, 2023
Accepted: July 24, 2023
Article in press: July 24, 2023
Published online: September 26, 2023
ARTICLE HIGHLIGHTS
Research background
Laparoscopic surgery has been widely used in the treatment of a variety of tumors, but it is still controversial in the treatment of gallbladder cancer. This is the first meta-analysis to compare laparoscopic radical resection (LRR) and open radical resection (ORR) in gallbladder carcinoma (GBC) directly.
Research motivation
This study compared LRR with traditional ORR in the management of GBC. It aimed to resolve the disputes faced by LRR and provide support for further research.
Research objectives
This study aimed to clarify the feasibility of LRR in GBC treatment, and encourage more surgeons to further carry out research on LRR, and move the minimally invasive treatment of gallbladder cancer forward.
Research methods
We systematically reviewed the literature on the LRR and ORR in GBC, and integrated the available data for meta-analysis. The Begg’s test and Egger’s test were used to assess potential publication bias, and sensitivity analysis was performed to evaluate the stability of the results.
Research results
This study found that the LRR group was comparable with the ORR group in long-term and short-term prognosis, and even showed advantages in some aspects, such as tumor-free survival (TFS) in the T2/tumor-node-metastasis (TNM) Ⅱ stage subgroup and postoperative length of stay (POLS). Although there is still a lack of support from randomized controlled trials (RCTs), this result will encourage surgeons to conduct further and more in-depth research.
Research conclusions
The meta-analysis results showed that LRR was not inferior to ORR in all measured outcomes and even showed superiority in the TFS of patients with stage T2/TNM Ⅱ disease and POLS. It is the first meta-analysis that excluded interference from simple cholecystectomy cases, and it is also the first time to conduct a subgroup analysis of the data after propensity score matching.
Research perspectives
LRR will inevitably play a more important role in the treatment of GBC, considering its minimally invasive characteristics and the advantage of enhanced postoperative recovery. But it requires further research, such as RCT or research on the combination of LRR and adjuvant therapy.
