Effectiveness of Laparoscopic Surgery for Gallstones and Common Bile Duct Lithiasis: a Systematic Overview

The aim of the present study was to evaluate the available evidence on the effectiveness of laparoscopic surgery for treating gallstones and common bile duct lithiasis (CBDL). A systematic overview was performed. Medline, EMBASE and The Cochrane Library were searched (1998-2008). Systematic reviews...

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Autores principales:	Manterola,Carlos, Pineda,Viviana, Tort,Montserrat, Targarona,Eduardo, Villegas Portero,Román, Alonso,Pablo
Lenguaje:	English
Publicado:	Sociedad Chilena de Anatomía 2010
Materias:	Cholecystolithiasis Choledocholithiasis Cholelithiasis Gallstones Laparoscopy Cholecystectomy Laparoscopic Technology Assessment Biomedical
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0717-95022010000300012
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spelling	oai:scielo:S0717-950220100003000122010-10-25Effectiveness of Laparoscopic Surgery for Gallstones and Common Bile Duct Lithiasis: a Systematic OverviewManterola,CarlosPineda,VivianaTort,MontserratTargarona,EduardoVillegas Portero,RománAlonso,Pablo Cholecystolithiasis Choledocholithiasis Cholelithiasis Gallstones Laparoscopy Cholecystectomy Laparoscopic Technology Assessment Biomedical The aim of the present study was to evaluate the available evidence on the effectiveness of laparoscopic surgery for treating gallstones and common bile duct lithiasis (CBDL). A systematic overview was performed. Medline, EMBASE and The Cochrane Library were searched (1998-2008). Systematic reviews (SR), clinical practice guidelines (CPG), randomised clinical trials (RCT) and observational studies were included. Internal validity and overall quality of the evidence were assessed. The available evidence was classified according to the Oxford Centre for Evidence Based Medicine proposal. 87 studies were included in this review (12 SR, 23 RCT, 3 CPG, 13 cohort studies, 3 cross-sectional studies, 2 case and control studies and 31 case series). Compared with open cholecystectomy, laparoscopic cholecystectomy (LC) is associated with shorter operating time, shorter hospital stay and better quality of life (high quality evidence). The use of antibiotic prophylaxis does not appear to reduce the infection rate in low-risk patients (high quality evidence). Although many techniques have been advocated to perform LC their effectiveness is as yet inconclusive (low-quality evidence). Two-stage surgery is the most appropriate strategy for high-risk patients with CBDL (high-quality evidence). Mortality is similar to open surgery, as the effectiveness is similar to that of endoscopic treatment (high-quality evidence). As a conclusion we can state that the evidence concerning the effectiveness of laparoscopic surgery for gallstones and CBDL is scarce and of low methodological quality and that better quality studies are warranted to assess these techniques more adequately.info:eu-repo/semantics/openAccessSociedad Chilena de AnatomíaInternational Journal of Morphology v.28 n.3 20102010-09-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0717-95022010000300012en10.4067/S0717-95022010000300012
institution	Scielo Chile
collection	Scielo Chile
language	English
topic	Cholecystolithiasis Choledocholithiasis Cholelithiasis Gallstones Laparoscopy Cholecystectomy Laparoscopic Technology Assessment Biomedical
spellingShingle	Cholecystolithiasis Choledocholithiasis Cholelithiasis Gallstones Laparoscopy Cholecystectomy Laparoscopic Technology Assessment Biomedical Manterola,Carlos Pineda,Viviana Tort,Montserrat Targarona,Eduardo Villegas Portero,Román Alonso,Pablo Effectiveness of Laparoscopic Surgery for Gallstones and Common Bile Duct Lithiasis: a Systematic Overview
description	The aim of the present study was to evaluate the available evidence on the effectiveness of laparoscopic surgery for treating gallstones and common bile duct lithiasis (CBDL). A systematic overview was performed. Medline, EMBASE and The Cochrane Library were searched (1998-2008). Systematic reviews (SR), clinical practice guidelines (CPG), randomised clinical trials (RCT) and observational studies were included. Internal validity and overall quality of the evidence were assessed. The available evidence was classified according to the Oxford Centre for Evidence Based Medicine proposal. 87 studies were included in this review (12 SR, 23 RCT, 3 CPG, 13 cohort studies, 3 cross-sectional studies, 2 case and control studies and 31 case series). Compared with open cholecystectomy, laparoscopic cholecystectomy (LC) is associated with shorter operating time, shorter hospital stay and better quality of life (high quality evidence). The use of antibiotic prophylaxis does not appear to reduce the infection rate in low-risk patients (high quality evidence). Although many techniques have been advocated to perform LC their effectiveness is as yet inconclusive (low-quality evidence). Two-stage surgery is the most appropriate strategy for high-risk patients with CBDL (high-quality evidence). Mortality is similar to open surgery, as the effectiveness is similar to that of endoscopic treatment (high-quality evidence). As a conclusion we can state that the evidence concerning the effectiveness of laparoscopic surgery for gallstones and CBDL is scarce and of low methodological quality and that better quality studies are warranted to assess these techniques more adequately.
author	Manterola,Carlos Pineda,Viviana Tort,Montserrat Targarona,Eduardo Villegas Portero,Román Alonso,Pablo
author_facet	Manterola,Carlos Pineda,Viviana Tort,Montserrat Targarona,Eduardo Villegas Portero,Román Alonso,Pablo
author_sort	Manterola,Carlos
title	Effectiveness of Laparoscopic Surgery for Gallstones and Common Bile Duct Lithiasis: a Systematic Overview
title_short	Effectiveness of Laparoscopic Surgery for Gallstones and Common Bile Duct Lithiasis: a Systematic Overview
title_full	Effectiveness of Laparoscopic Surgery for Gallstones and Common Bile Duct Lithiasis: a Systematic Overview
title_fullStr	Effectiveness of Laparoscopic Surgery for Gallstones and Common Bile Duct Lithiasis: a Systematic Overview
title_full_unstemmed	Effectiveness of Laparoscopic Surgery for Gallstones and Common Bile Duct Lithiasis: a Systematic Overview
title_sort	effectiveness of laparoscopic surgery for gallstones and common bile duct lithiasis: a systematic overview
publisher	Sociedad Chilena de Anatomía
publishDate	2010
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0717-95022010000300012
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Effectiveness of Laparoscopic Surgery for Gallstones and Common Bile Duct Lithiasis: a Systematic Overview

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