Needlescopic versus laparoscopic cholecystectomy: a meta-analysis.
BACKGROUND
To systematically analyse clinical trials on needlescopic (NC) versus laparoscopic cholecystectomy (LC) that evaluated the effectiveness of both procedures for the management of cholelithiasis.


METHODS
A systematic review of the literature was undertaken. Clinical trials on NC versus LC were selected according to specific criteria and analyzed to generate summative data expressed in standardized mean difference.


RESULTS
Sixteen trials on NC versus LC encompassing 1549 patients were retrieved from electronic databases. Only six randomized controlled trials on 317 patients qualified for the meta-analysis according to inclusion criteria. NC was associated with longer operative time and higher conversion rate as compared with LC. There was statistically significant heterogeneity among trials. Intraoperative complications, postoperative complications and total stay in hospital were not significantly different. NC was superior to LC in terms of less post-operative pain and better cosmetic outcomes.


CONCLUSIONS
NC is a safe and effective procedure for the management of gallstone disease. NC is as effective as LC for perioperative complications and total stay in hospital. NC is superior to LC for less post-operative pain and better cosmetic results. NC is associated with longer operative time and higher conversion rate.
Sajid
Muhammad S
MS
Department of Colorectal Surgery, Worthing Hospital, Worthing, West Sussex, UK. surgeon1wrh@hotmail.com
Khan
Munir A
MA
Ray
Kausik
K
Cheek
Elizabeth
E
Baig
Mirza K
MK
D017081:Cholecystectomy, Laparoscopic / Q000295:instrumentation / Q000379:methods; D002769:Cholelithiasis / Q000175:diagnosis / Q000601:surgery*; D002986:Clinical Trials as Topic; D006801:Humans; D007431:Intraoperative Complications; D007902:Length of Stay; D010149:Postoperative Pain / Q000517:prevention & control*; D011183:Postoperative Complications; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome