title: Laparoscopic cholecystectomy versus minilaparotomy in cholelithiasis: systematic review and meta-analysis.
abstract: BACKGROUND
  A introdução da técnica laparoscópica em 1985 foi um fator importante na colecistectomia por representar técnica menos invasiva, resultado estético melhor e menor risco cirúrgico comparado ao procedimento laparotômico.
  
  
  OBJECTIVE
  To compare laparoscopic and minilaparotomy cholecystectomy in the treatment of cholelithiasis.
  
  
  METHODS
  A systematic review of randomized clinical trials, which included studies from four databases (Medline, Embase, Cochrane and Lilacs) was performed. The keywords used were "Cholecystectomy", "Cholecystectomy, Laparoscopic" and "Laparotomy". The methodological quality of primary studies was assessed by the Grade system.
  
  
  RESULTS
  Ten randomized controlled trials were included, totaling 2043 patients, 1020 in Laparoscopy group and 1023 in Minilaparotomy group. Laparoscopic cholecystectomy dispensed shorter length of hospital stay (p<0.00001) and return to work activities (p<0.00001) compared to minilaparotomy, and the minilaparotomy shorter operative time (p<0.00001) compared to laparoscopy. Laparoscopy decrease the risk of postoperative pain (NNT=7) and infectious complications (NNT=50). There was no statistical difference between the two groups regarding conversion (p=0,06) and surgical reinterventions (p=0,27), gall bladder's perforation (p=0,98), incidence of common bile duct injury (p=1.00), surgical site infection (p=0,52) and paralytic ileus (p=0,22).
  
  
  CONCLUSIONS
  In cholelithiasis, laparoscopic cholecystectomy is associated with a lower incidence of postoperative pain and infectious complications, as well as shorter length of hospital stay and time to return to work activities compared to minilaparotomy cholecystectomy.
authors.affiliation: Departament of General Surgery, Guilherme Álvaro Hospital, UNILUS, Santos, SP, Brazil.
authors.forename: Paula Marcela Vilela
authors.initials: PM
authors.lastname: Castro
authors.affiliation: Departament of General Surgery, Guilherme Álvaro Hospital, UNILUS, Santos, SP, Brazil.
authors.forename: Denise
authors.initials: D
authors.lastname: Akerman
authors.affiliation: Departament of General Surgery, Guilherme Álvaro Hospital, UNILUS, Santos, SP, Brazil.
authors.forename: Carolina Brito
authors.initials: CB
authors.lastname: Munhoz
authors.affiliation: Departament of General Surgery, Guilherme Álvaro Hospital, UNILUS, Santos, SP, Brazil.
authors.forename: Iara do
authors.initials: Id
authors.lastname: Sacramento
authors.affiliation: Departament of General Surgery, Guilherme Álvaro Hospital, UNILUS, Santos, SP, Brazil.
authors.forename: Mônica
authors.initials: M
authors.lastname: Mazzurana
authors.affiliation: Departament of General Surgery, Guilherme Álvaro Hospital, UNILUS, Santos, SP, Brazil.
authors.forename: Guines Antunes
authors.initials: GA
authors.lastname: Alvarez
mesh_terms: D017081:Cholecystectomy, Laparoscopic; D002769:Cholelithiasis / Q000601:surgery*; D006801:Humans; D007813:Laparotomy / Q000379:methods*; D016032:Randomized Controlled Trials as Topic