title: Laparoscopic fenestration vs open fenestration in patients with congenital hepatic cysts: a meta-analysis.
abstract: OBJECTIVE
  To determine whether the outcomes of laparoscopic fenestration (LF) were superior to open fenestration (OF) for congenital liver cysts.
  
  
  METHODS
  Comparative studies published between January 1991 and May 2010 on Medline (Ovid), Emsco, PubMed, Science Direct; Cochrane Reviews; CNKI; Chinese Biomedical Database, VIP and other electronic databases were searched. Randomized controlled trials (RCTs) and retrospective case-control studies on the management of congenital hepatic cysts were collected according to the pre-determined eligibility criteria to establish a literature database. Retrieval was ended in May 2010. Meta-analysis was performed using RevMan 5.0 software (Cochrane library).
  
  
  RESULTS
  Nine retrospective case-control studies involving 657 patients, comparing LF with OF were included for the final pooled analysis. The meta-analysis results showed less operative time [mean difference (MD): -28.76, 95% CI: -31.03 to 26.49, P < 0.00001]; shorter hospital stay (MD: -3.35, 95% CI: -4.46 to -2.24, P < 0.00001); less intraoperative blood loss (MD: -40.18, 95% CI: -52.54 to -27.82, P < 0.00001); earlier return to regular diet (MD: -29.19, 95% CI: -30.65 to -27.72, P < 0.00001) and activities after operation (MD: -21.85, 95% CI: -31.18 to -12.51, P < 0.0001) in LF group; there was no significant difference between the two groups in postoperative complications (odds ratio: 0.99, 95% CI: 0.41 to 2.38, P = 0.98) and cysts recurrence rates.
  
  
  CONCLUSIONS
  The short-term outcomes of LF for patients with congenital hepatic cysts were superior to open approach, but its long-term outcomes should be verified by further RCTs and extended follow-up.
authors.affiliation: Department of Hepatobiliary Pancreatic Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
authors.forename: Jian-Guo
authors.initials: JG
authors.lastname: Qiu
authors.forename: Hong
authors.initials: H
authors.lastname: Wu
authors.forename: Hui
authors.initials: H
authors.lastname: Jiang
authors.forename: Ji-Wei
authors.initials: JW
authors.lastname: Huang
authors.forename: Prasoon
authors.initials: P
authors.lastname: Pankaj
authors.forename: Ying-Long
authors.initials: YL
authors.lastname: Xu
authors.forename: Jing-Zhou
authors.initials: JZ
authors.lastname: Wang
authors.forename: Yong
authors.initials: Y
authors.lastname: Zeng
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003560:Cysts / Q000151:congenital* / Q000473:pathology* / Q000601:surgery*; D016208:Databases, Factual; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008099:Liver / Q000473:pathology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic; D055815:Young Adult