title: Postoperative pulmonary function in open versus laparoscopic cholecystectomy: a meta-analysis of the Tiffenau index.
abstract: BACKGROUND
  Available scientific literature about open cholecystectomy (OC) and laparoscopic cholecystectomy (LC) does not show univocal results in terms of postoperative pulmonary function. A meta-analysis was carried out to evaluate the postoperative pulmonary function after OC and LC focusing on the Tiffenau index.
  
  
  METHODS
  Electronic databases were consulted (Cochrane Library, Embase and Pubmed). Standardized mean difference (SMD) with 95% CI was calculated for the Tiffenau Index. The kappa test was performed to evaluate agreement between the reviewers regarding the quality of the selected studies. A sensitivity analysis was carried out to assess the robustness of our study. Heterogeneity among studies was tested by using a chi(2) test at 0.05 significance level. A random effects model meta-analysis was performed.
  
  
  RESULTS
  Meta-analysis of the 13 articles included, resulted in a SMD of 53% (95% CI 0.04, 1.02) for the Tiffenau Index in favor of laparoscopic cholecystectomy. The chi(2) test analysis showed the presence of heterogeneity among studies (Tiffenau index chi(2) = 99.97, p = 0.03). The sensitivity analysis confirms the validity of our results.
  
  
  CONCLUSIONS
  Postoperative pulmonary function is better preserved after laparoscopic cholecystectomy than open cholecystectomy.
authors.affiliation: Department of Public Health, Università Cattolica S. Cuore, Rome, Italy. gdamiani@rm.unicatt.it
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Damiani
authors.forename: Luigi
authors.initials: L
authors.lastname: Pinnarelli
authors.forename: Annalisa
authors.initials: A
authors.lastname: Sammarco
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Sommella
authors.forename: Marsilio
authors.initials: M
authors.lastname: Francucci
authors.forename: Walter
authors.initials: W
authors.lastname: Ricciardi
mesh_terms: D002763:Cholecystectomy; D017081:Cholecystectomy, Laparoscopic; D006801:Humans; D008954:Models, Biological; D011184:Postoperative Period; D012107:Research Design; D012129:Respiratory Function Tests