Evidence map›Paper›PMID 29556977›Full record

SynthesisSurgical endoscopy2018

Outcome trends and safety measures after 30 years of laparoscopic cholecystectomy: a systematic review and pooled data analysis.

Philip H Pucher, L Michael Brunt, Neil Davies, Ali Linsk, Amani Munshi, H Alejandro Rodriguez, Abe Fingerhut, Robert D Fanelli, Horacio Asbun, Rajesh Aggarwal and 1 more

Open access · hybridAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Surgical endoscopy, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 136 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
136citing papers in PubMed, 9 pooled it
15.0field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

136 citing papers in PubMed, 9 syntheses or guidelines pooled it, 274 citations in OpenAlex.

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  9. Clear Vision, Clear Savings: Enhancing Efficiency in Minimally Invasive Surgery.JSLS : Journal of the Society of Laparoendoscopic Surgeons
    Pooled it
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76 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 7 institutions in 3 countries.

Philip H PucherDepartment of Surgery and Cancer, Imperial College London, London, UK. p.pucher@imperial.ac.uk.
L Michael BruntSection of Minimally Invasive Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA.
Neil DaviesMRC Integrative Epidemiology Unit, School of Social and Community Medicine, University of Bristol, Bristol, UK.
Ali LinskBeth Israel Deaconess Medical Center, Boston, MA, USA.
Amani MunshiDepartment of Surgery, University Hospitals St. John Medical Center, Westlake, OH, USA.
H Alejandro RodriguezDepartment of Surgery, University of Washington, Seattle, WA, USA.
Abe FingerhutSection for Surgical Research, Department of Surgery, Medical University of Graz, Graz, Austria.
Robert D FanelliDepartment of Surgery and Division of Gastroenterology, The Guthrie Clinic, Sayre, PA, USA.
Horacio AsbunDepartment of Surgery, Mayo Clinic Florida, Jacksonville, FL, USA.
Rajesh AggarwalDepartment of Surgery, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA.
SAGES Safe Cholecystectomy Task Force
Beth Israel Deaconess Medical Center · USThomas Jefferson University · USUniversity of Washington · USWashington University in St. Louis · USImperial College London · GBJacksonville College · USMedical University of Graz · AT

Funding

Medical Research Council MC_UU_12013/9
6 · The paper itself

Abstract

backgroundLaparoscopic cholecystectomy (LC), one of the most commonly performed surgical procedures, remains associated with significant major morbidity including bile leak and bile duct injury (BDI). The effect of changes in practice over time, and of interventions to improve patient safety, on morbidity rates is not well understood. The aim of this review was to describe current incidence rates and trends for BDI and other complications during and after LC, and to identify risk factors and preventative measures associated with morbidity and BDI.

methodsPubMed, MEDLINE, and Web of Science database searches and data extraction were conducted for studies which reported individual complications and complication rates following laparoscopic cholecystectomy in a representative population. Outcomes data were pooled. Meta-regression analysis was performed to assess factors associated with conversion, morbidity, and BDI rates.

resultsOne hundred and fifty-one studies reporting outcomes for 505,292 patients were included in the final quantitative synthesis. Overall morbidity, BDI, and mortality rates were 1.6-5.3%, 0.32-0.52%, and 0.08-0.14%, respectively. Reported BDI rates reduced over time (1994-1999: 0.69(0.52-0.84)% versus 2010-2015 0.22(0.02-0.40)%, p = 0.011). Meta-regression analysis suggested higher conversion rates in developed versus developing countries (4.7 vs. 3.4%), though a greater degree of reporting bias was present in these studies, with no other significant associations identified.

conclusionsOverall, trends suggest a reduction in BDI over time with unchanged morbidity and mortality rates. However, data and reporting are heterogenous. Establishment of international outcomes registries should be considered.

Indexed as

Cholecystectomy, LaparoscopicPostoperative ComplicationsBile DuctsData AnalysisDatabases, FactualGuideline AdherenceHumansPatient SafetyPractice Guidelines as TopicBile duct injuryBile leakCholecystectomyLaparoscopyOpenOutcomes

Identifiers

PMID29556977
PMCPMC5897463
OpenAlexW4243063216

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.