557 Laparoscopic versus robotic cholecystectomy: a meta-analysis to differentiate between postoperative outcomes
Anurag Singh, Mandeep Kaur, Christi Swaminathan, Parv Sains, Krishna Singh, Muhammad Shafique- Surgery
Abstract
Objective
Robotic cholecystectomy (RC) may be an option to replace conventional laparoscopic
cholecystectomy (LC) due to several reported advantages. The objective of this study is to compare the postoperative surgical outcomes in patients undergoing RC versus LC.
Materials and methods
RCTs reporting postoperative outcomes in patients undergoing RC versus LC were selected from the search of standard medical electronic databases and analysis was conducted by using the principles of meta-analysis on the statistical software RevMan version 5.
Results
Two RCTs on 196 (113 patients in RC group and 83 patients in LC group) patients were found suitable for meta-analysis according to the inclusion criteria. In the random effects model analysis, the duration of operation [standardised mean difference -15.83, 95%, CI (-22.99, -8.67), Z = 4.33, p < 0.0001] was shorter in the LC group. However, the risk of bile leak [standardised mean difference 3.15, 95%, CI (0.69, 14.44), Z = 1.48, p = 0.14] and postoperative complications [standardised mean difference -0.48, 95%, CI (0.10, 2.33), Z =0.91, p = 0.36] were statistically similar between RC and LC groups. There was no heterogeneity (Tau 2 = 0.09; Chi 2 = 1.06, df = 1; (p = 0.30; I 2 = 6 %) between included RCTs.
Conclusion
RC failed to prove any clinical advantage over LC for postoperative outcomes including longer duration of operation. These findings are insufficient to draw a stronger conclusion due to the paucity of RTCs and a major multicentre RCT is required to strengthen the existing evidence.