Laparoscopic VS open hepatectomy for hepatolithiasis: An updated systematic review and meta-analysis

AIM To perform a meta-analysis on laparoscopic hepatectomy VS conventional liver resection for treating hepatolithiasis. METHODS We conducted a systematic literature search on PubMed, Embase, Web of Science and Cochrane Library, and undertook a meta-analysis to compare the efficacy and safety of laparoscopic hepatectomy VS conventional open liver resection for local hepatolithiasis in the left or right lobe. Intraoperative and postoperative outcomes (time, estimated blood loss, blood transfusion rate, postoperative intestinal function recovery time, length of hospital stay, postoperative complication rate, initial residual stone, final residual stone and stone recurrence) were analyzed systematically. RESULTS A comprehensive literature search retrieved 16 publications with a total of 1329 cases. Meta-analysis of these studies showed that the laparoscopic approach for hepatolithiasis was associated with significantly less intraoperative estimated blood loss [weighted mean difference (WMD): 61.56, 95% confidence interval (CI): 14.91-108.20, P = 0.01], lower blood transfusion rate [odds ratio (OR): 0.41, 95%CI: 0.22-0.79, P = 0.008], shorter intestinal function recovery time (WMD: 0.98, 95%CI: 0.47-1.48, P = 0.01), lower total postoperative complication rate (OR: 0.52, 95%CI: 0.39-0.70, P < 0.0001) and shorter stay in hospital (WMD: 3.32, 95%CI: 2.32-4.32, P < 0.00001). In addition, our results showed no significant differences between the two groups in operative time (WMD: 21.49, 95%CI: 0.27-43.24, P = 0.05), residual stones (OR: 0.79, 95%CI: 0.50-1.25, P = 0.31) and stone recurrence (OR: 0.34, 95%CI: 0.11-1.08, P = 0.07). Furthermore, with subgroups analysis, our results proved that the laparoscopic approach for hepatolithiasis in the left lateral lobe and left side could achieve satisfactory therapeutic effects. CONCLUSION The laparoscopic approach is safe and effective, with less intraoperative estimated blood loss, fewer postoperative complications, reduced length of hospital stay and shorter intestinal function recovery time than with conventional approaches.

[1]  Leizhen Zheng,et al.  Prognostic value of the Glasgow prognostic score in colorectal cancer: a meta-analysis of 9,839 patients , 2018, Cancer management and research.

[2]  Yong Li,et al.  Laparoscopic Versus Open Left-Sided Hepatectomy for Hepatolithiasis: A Systematic Review and Meta-Analysis. , 2017, Journal of laparoendoscopic & advanced surgical techniques. Part A.

[3]  R. Wan,et al.  Laparoscopic left-sided hepatectomy for the treatment of hepatolithiasis: A comparative study with open approach. , 2017, International journal of surgery.

[4]  M. den Dulk,et al.  Multicenter Observational Study of Adhesion Formation After Open-and Laparoscopic Surgery for Colorectal Cancer , 2017, Annals of surgery.

[5]  X. Liang,et al.  Total laparoscopic left hepatectomy for primary hepatolithiasis: Eight-year experience in a single center. , 2016, Surgery.

[6]  T. Klatte,et al.  Surgical Management of Adrenocortical Carcinoma: Impact of Laparoscopic Approach, Lymphadenectomy, and Surgical Volume on Outcomes-A Systematic Review and Meta-analysis of the Current Literature. , 2016, European urology focus.

[7]  Xiao-ming Hong,et al.  Laparoscopic versus open left hemihepatectomy for hepatolithiasis. , 2015, The Journal of surgical research.

[8]  M. Qin,et al.  Pure Laparoscopic Versus Open Liver Resection in Treatment of Hepatolithiasis Within the Left Lobes: A Randomized Trial Study , 2015, Surgical laparoscopy, endoscopy & percutaneous techniques.

[9]  S. Zou,et al.  Clinical efficacy of laparoscopic left hemihepatectomy for the treatment of intrahepatic bile duct stones , 2015 .

[10]  Yoo-Seok Yoon,et al.  Laparoscopic Approach for Right-Sided Intrahepatic Duct Stones: A Comparative Study of Laparoscopic Versus Open Treatment , 2015, World Journal of Surgery.

[11]  Y. Choi,et al.  Initial Experience of Laparoscopic Hepatectomy for Intrahepatic Duct (IHD) Stones: Comparison with Open Hepatectomy , 2014 .

[12]  C. Manterola,et al.  [Hierarchy of evidence: levels of evidence and grades of recommendation from current use]. , 2014, Revista chilena de infectologia : organo oficial de la Sociedad Chilena de Infectologia.

[13]  G. Song,et al.  Comparison of Laparoscopic Versus Open Left Hemihepatectomy for Left-Sided Hepatolithiasis , 2014, International journal of medical sciences.

[14]  Shou‐Tung Chen,et al.  Hepatic resection for bilateral hepatolithiasis: a 20‐year experience , 2013, ANZ journal of surgery.

[15]  Fan Zhou,et al.  Laparoscopic hepatectomy is associated with a higher incident frequency in hepatolithiasis patients , 2013, Surgery Today.

[16]  P. Bie,et al.  Laparoscopic hepatectomy with bile duct exploration for the treatment of hepatolithiasis: an experience of 116 cases. , 2013, Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver.

[17]  Tianxin Lin,et al.  Laparoendoscopic single-site nephrectomy compared with conventional laparoscopic nephrectomy: a systematic review and meta-analysis of comparative studies. , 2012, European urology.

[18]  B. Peng,et al.  Outcomes of Liver Resection for Intrahepatic Stones: A Comparative Study of Unilateral Versus Bilateral Disease , 2012, Annals of surgery.

[19]  S. Rubertsson,et al.  High intra‐abdominal pressure during experimental laparoscopic liver resection reduces bleeding but increases the risk of gas embolism , 2011, The British journal of surgery.

[20]  Kun-Ming Chan,et al.  Right hepatectomy by the anterior method with liver hanging versus conventional approach for large hepatocellular carcinomas , 2010, The British journal of surgery.

[21]  Wei-jian Zhang,et al.  Laparoscopic vs open left hepatectomy for hepatolithiasis. , 2010, World journal of gastroenterology.

[22]  W. Lau,et al.  Hepatectomy for Bilateral Primary Hepatolithiasis: A Cohort Study , 2010, Annals of surgery.

[23]  Ho‐Seong Han,et al.  Laparoscopic Treatment for Intrahepatic Duct Stones in the Era of Laparoscopy: Laparoscopic Intrahepatic Duct Exploration and Laparoscopic Hepatectomy , 2009, Annals of surgery.

[24]  Zhi-Qiang Feng,et al.  Liver resection for benign hepatic lesions: a retrospective analysis of 827 consecutive cases. , 2008, World journal of gastroenterology.

[25]  Dan-song Yu,et al.  [Laparoscopic anatomical hepatectomies for intrahepatic bile duct stone]. , 2008, Zhongguo yi xue ke xue yuan xue bao. Acta Academiae Medicinae Sinicae.

[26]  Jin‐Young Jang,et al.  Selection of Appropriate Liver Resection in Left Hepatolithiasis Based on Anatomic and Clinical Study , 2008, World Journal of Surgery.

[27]  X. Liang,et al.  Laparoscopic hepatectomy for hepatolithiasis: a feasibility and safety study in 29 patients , 2007, Surgical Endoscopy.

[28]  M. Cheung,et al.  Liver resection for intrahepatic stones. , 2005, Archives of surgery.

[29]  M. Gagner,et al.  Laparoscopic liver resection: benefits and controversies. , 2004, The Surgical clinics of North America.

[30]  Chien-Hua Chen,et al.  Long-term outcome of percutaneous transhepatic cholangioscopic lithotomy for hepatolithiasis , 2003, American Journal of Gastroenterology.

[31]  T. Hwang,et al.  Intrahepatic segmental bile duct patterns in hepatolithiasis: a comparative cholangiographic study between Taiwan and Japan. , 2003, Journal of hepato-biliary-pancreatic surgery.

[32]  H. Yamaue,et al.  Long-Term Prognosis After Treatment of Patients with Choledocholithiasis , 2003, Annals of surgery.

[33]  Douglas G Altman,et al.  Effect of arterial revascularisation on survival: a systematic review of studies comparing bilateral and single internal mammary arteries , 2001, The Lancet.

[34]  Myung-Hwan Kim,et al.  Percutaneous transhepatic cholangioscopic treatment for hepatolithiasis: an evaluation of long-term results and risk factors for recurrence. , 2001, Gastrointestinal endoscopy.

[35]  T. Hwang,et al.  Surgical treatment of hepatolithiasis: long-term results. , 1996, Surgery.

[36]  Jin‐Young Jang,et al.  Comparison of laparoscopic versus open left-sided hepatectomy for intrahepatic duct stones , 2015, Surgical Endoscopy.

[37]  P. Tugwell,et al.  The Newcastle-Ottawa Scale (NOS) for Assessing the Quality of Nonrandomised Studies in Meta-Analyses , 2014 .

[38]  E. Jung,et al.  The Feasibility of Laparoscopic Hepatectomy for the Patients with Left Intrahepatic Stones , 2010 .

[39]  Adriana Yoshii,et al.  Analysis of the reporting of search strategies in Cochrane systematic reviews. , 2009, Journal of the Medical Library Association : JMLA.

[40]  E. Shaffer.  Gallstone disease: Epidemiology of gallbladder stone disease. , 2006, Best practice & research. Clinical gastroenterology.

[41]  Cochrane Handbook for Systematic Reviews of Interventions Edited by Julian P. T. Higgins & , 2006 .

[42]  E. Shaffer.  Epidemiology of gallbladder stone disease , 2006 .