Karjol Uday, Jonnada Pavan, Anwar Ali Zaid, Chandranath Ajay, Cheruku Sushama
Surgical Oncology, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka India.
Pathology, Am Path Laboratories, Hyderabad, Telangana India.
Indian J Surg Oncol. 2024 May;15(Suppl 2):218-225. doi: 10.1007/s13193-022-01654-z. Epub 2022 Nov 1.
Laparoscopy in gallbladder cancer (GBC) has a possible role in staging, radical cure, and palliation in gallbladder cancer. However, a few studies have advocated the use of laparoscopic approach and concluded the safety of this approach. This present study was undertaken to determine the safety and feasibility between open and laparoscopic cholecystectomy in patients with the non-metastatic GBC.
A systematic database search was performed in MEDLINE, Embase, and Google Scholar for relevant articles. As a result, a list of such studies, clinical trials, published in English up to May 2021, was obtained,14 studies were included and statistical analysis was conducted using RevMan software 5.3 (The Nordic Cochrane Centre).
The 5-year survival rate was reported in 13 out of 14 studies (1388 patients), and all compared laparoscopic and open approach. There was no significant heterogeneity in between the studies (chi-square, 10.66; df, 12; , 0%). There was significant higher overall survival in open group (389/850 vs 194/538 or 1.45, 95% CI (1.12-1.88), value, 0.005). There was no significant difference in recurrence rate, operative time, blood loss, lymph node yield, and postoperative complication in between open and laparoscopic groups.
Our present study demonstrates that overall survival is significantly increased with open approach when compared with laparoscopic approach. There is no difference in recurrence rate, operative time, blood loss, lymph node yield, and postoperative complications between the open and laparoscopic cholecystectomy groups.
腹腔镜检查在胆囊癌（GBC）中对分期、根治性治疗和姑息治疗可能具有一定作用。然而，仅有少数研究提倡使用腹腔镜手术方法并证实了该方法的安全性。本研究旨在确定非转移性胆囊癌患者行开放与腹腔镜胆囊切除术的安全性和可行性。
在MEDLINE、Embase和谷歌学术中进行系统的数据库检索以获取相关文章。结果，获得了截至2021年5月以英文发表的此类研究、临床试验列表，纳入14项研究并使用RevMan软件5.3（北欧 Cochrane中心）进行统计分析。
14项研究中的13项（1388例患者）报告了5年生存率，所有研究均比较了腹腔镜和开放手术方法。各研究之间无显著异质性（卡方检验，χ² = 10.66；自由度df = 12；P = 0%）。开放手术组的总生存率显著更高（389/850对比194/538，比值比OR = 1.45，95%置信区间CI（1.12 - 1.88），P值 = 0.005）。开放组与腹腔镜组在复发率、手术时间、失血量、淋巴结获取量及术后并发症方面无显著差异。
我们目前的研究表明，与腹腔镜手术方法相比，开放手术方法可显著提高总生存率。开放与腹腔镜胆囊切除术组在复发率、手术时间、失血量、淋巴结获取量及术后并发症方面无差异。
