A Systemic Review and Meta-analysis of Laparoscopic Surgery Versus Open Surgery for Gallbladder Cancer.

Area of Science:

• Surgical Oncology
• Gastroenterology
• Minimally Invasive Surgery

Background:

• Laparoscopic surgery for gallbladder cancer (GBC) is explored for staging, cure, and palliation.
• Limited studies suggest the safety and feasibility of laparoscopic approaches in GBC management.
• This study evaluates open versus laparoscopic cholecystectomy in non-metastatic GBC.

Purpose of the Study:

• To determine the safety and feasibility of open versus laparoscopic cholecystectomy for non-metastatic gallbladder cancer.
• To compare survival rates and oncological outcomes between the two surgical approaches.
• To assess operative parameters and postoperative complications.

Main Methods:

• A systematic literature search was conducted across MEDLINE, Embase, and Google Scholar up to May 2021.
• Fourteen relevant studies and clinical trials were included in the analysis.
• Statistical analysis was performed using RevMan software 5.3.

Main Results:

• Thirteen studies (1388 patients) reported 5-year survival rates, showing significantly higher survival in the open surgery group (HR 1.45, P=0.005).
• No significant heterogeneity was observed among the included studies (I²=0%).
• Recurrence rates, operative time, blood loss, lymph node yield, and postoperative complications were comparable between open and laparoscopic groups.

Conclusions:

• Open cholecystectomy is associated with significantly improved overall survival in patients with non-metastatic gallbladder cancer.
• Laparoscopic cholecystectomy is a feasible and safe alternative with comparable outcomes regarding recurrence and complications.
• The choice of surgical approach should consider the survival benefit associated with open surgery for GBC.