Laparoscopic versus open hepatectomy approach for regional hepatolithiasis: A meta-analysis

Background: In the present study, we aimed to compare laparoscopic hepatectomy (LH) with open hepatectomy (OH) approach in patients with regional hepatolithiasis (RHL) using meta-analytical techniques. Methods: A systematic review of the literature was performed to identify studies comparing LH and OH in the management of RHL. Operative parameters, postoperative outcomes, and postoperative complications were evaluated. Meta-analysis was performed using Review Manage Version 5.0 software. Results: Nine studies matched the selection criteria, which included 719 patients (LH = 333 and OH = 386). LH was associated with shorter hospital stay (p < 0.00001), earlier oral intake (p < 0.00001), and fewer complications (p = 0.01). No significant statistical divergences were found between the LH and OH groups in terms of operative time (p = 0.48), blood loss (p = 0.07), intraoperative transfusion rate (p = 0.69), initial stone clearance rate (p = 0.33), and postoperative stone recurrence rate (p = 0.23). Conclusion: LH for regional hepatolithiasis appears to be a promising treatment modality for patients with intrahepatic stones. However, large numbers of patients and prospective, randomized, controlled studies are required to lead to a more comprehensive comparison of the two procedures. Copyright (C) 2017, the Chinese Medical Association. Published by Elsevier Taiwan LLC. This is an open access article under the CC BY-NC-ND license.