Lei J, et al. - The clinical outcomes of minimally invasive surgery (MIS) hepatectomy were compared with those of open hepatectomy in hepatolithiasis patients. For hepatolithiasis patients, MIS hepatectomy proved a safe approach. MIS hepatectomy resulted in significant reduction in intraoperative blood loss, blood transfusion, postoperative hospital stay time and complications. MIS hepatectomy and open hepatectomy were similar in terms of stone clearance and recurrence rates.

Methods

• Researchers performed a systematic literature search using PubMed, Embase and Cochrane Library databases.
• With Stata version 12.0 software, they analyzed the data.
• The potential sources of heterogeneity were explored using meta-regression analysis.
• The publication biases were evaluated using Egger's tests and Begg's funnel plots.

Results

• Researchers identified 12 nonrandomized controlled trials.
• In MIS hepatectomy (SMD = -0.226, P=0.000), the volume of intraoperative blood loss was significantly less compared with open hepatectomy.
• MIS hepatectomy also had lower intraoperative blood transfusion rate (RR = 0.569, P=0.003).
• they noticed a shorter length of postoperative hospital stay with MIS hepatectomy (SMD = -0.537, P=0.000).
• A lower rate of postoperative complications was observed with MIS hepatectomy than open hepatectomy (RR = 0.595, P=0.000).
• However, a longer operation time was taken by surgeons for performing MIS hepatectomy (SMD = 0.473, P=0.005).
• MIS and open hepatectomy showed no significant differences in terms of initial stone clearance rate (RR = 1.33, P=0.218), the final stone clearance rate (RR = 1.040, P=0.131), the stone recurrence rate (R R= 0.558, P=0.072) or the cholangitis recurrence rate (RR = 0.610, P=0.285).