scholarly journals Preoperative Dexmedetomidine and intraoperative bradycardia in laparoscopic cholecystectomy: meta-analysis with trial sequential analysis

2022 ◽  
Author(s):  
Alessandro De Cassai ◽  
Nicolò Sella ◽  
Federico Geraldini ◽  
Francesco Zarantonello ◽  
Tommaso Pettenuzzo ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Sequential Analysis ◽  
Meta Analysis ◽  
Trial Sequential Analysis

Meta-analysis and trial sequential analysis of three-port vs four-port laparoscopic cholecystectomy (level 1 evidence)

2021 ◽  
Vol 73 (2) ◽  
pp. 451-471
Author(s):  
Shahab Hajibandeh ◽  
David A. Finch ◽  
Ali Yasen Y. Mohamedahmed ◽  
Amir Iskandar ◽  
Gowtham Venkatesan ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Sequential Analysis ◽  
Meta Analysis ◽  
Trial Sequential Analysis ◽  
Level 1

TP6.1.8 Meta-analysis and trial sequential analysis of three-port versus four-port laparoscopic cholecystectomy (Level 1 Evidence)

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Shahab Hajibandeh ◽  
David A Finch ◽  
Shahin Hajibandeh ◽  
Thomas Satyadas
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Hospital Stay ◽  
Sequential Analysis ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
Trial Sequential Analysis ◽  
Analysis Model ◽  
Visceral Injury ◽  
Open Operation ◽  
Level 1

Abstract Aims to compare the outcomes of three-port and four-port laparoscopic cholecystectomy. Methods In compliance with PRISMA statement standards, electronic databases were searched to identify all comparative studies investigating outcomes of three-port versus four-port laparoscopic cholecystectomy. Two techniques were compared using direct comparison meta-analysis model. The risks of type 1 or type 2 error in the meta-analysis model were assessed using trial sequential analysis model. The certainty of the available evidence was assessed using GRADE system. Random effects modelling was applied to calculate pooled outcome data. Results Analysis of 2524 patients from 17 studies showed that three-port and four-port laparoscopic cholecystectomy techniques were comparable in terms of operative time (MD:-0.13,P=0.88), conversion to open operation (OR:0.80,P=0.43), gallbladder perforation (OR:1.43,P=0.13), bleeding from gallbladder bed (OR: 0.81, P = 0.34), bile duct injury (RD: 0.00, P = 0.97), iatrogenic visceral injury (RD:-0.00,P=0.81), bile or stone spillage (OR:1.67,P=0.08), port site infection (OR:0.90,P=0.76) and need for reoperation (RD:-0.00,P=0.94). However, the three-port technique was associated with lower VAS pain score at 12 hours (MD:-0.66,P<0.00001) and 24 hours (MD:-0.54,P<0.00001) postoperatively, shorter length of hospital stay (MD: -0.09, P = 0.41), and shorter time to return to normal activities (MD:-0.79,P=0.02). Conclusions Robust evidence (Level 1 with high certainty) suggests that in an elective setting with uncomplicated cholelithiasis as indication for cholecystectomy, three-port laparoscopic cholecystectomy is comparable with the four-port technique in terms of procedural and morbidity outcomes and may be associated with less postoperative pain, shorter length of hospital stay and shorter time to return to normal activities.

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