Evidence map›Paper›PMID 42572550›Full record

ReviewCureus2026

Laparoscopic Versus Open Cholecystectomy in Older Adults: A Systematic Review and Meta-Analysis of Postoperative Outcomes (2000-2026).

Ahmed Mahmoud I Hassan, Bassam Omar M Abobakr, Abdulkareem Saad Alshamrani, Rayan Khaled Alrashed, Reem Ahmed Alshanbari, Mansour Hasen Alkhammash, Rahaf Abdulmohsen Masoud Almuqati, Hassan Mohammed H Alshahrani, Rakan Waleed Mal, Waseel Naif Waseel Alrouqi and 2 more

Abstract readReview
In one paragraph

Review in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

12 authors.

Ahmed Mahmoud I HassanCollege of Medicine, Ibn Sina National College for Medical Studies, Jeddah, SAU.
Bassam Omar M AbobakrCollege of Medicine, Ibn Sina National College for Medical Studies, Jeddah, SAU.
Abdulkareem Saad AlshamraniDepartment of General Surgery, King Abdulaziz Hospital, Jeddah, SAU.
Rayan Khaled AlrashedCollege of Medicine, Ibn Sina National College for Medical Studies, Jeddah, SAU.
Reem Ahmed AlshanbariCollege of Medicine, Ibn Sina National College for Medical Studies, Jeddah, SAU.
Mansour Hasen AlkhammashCollege of Medicine, Ibn Sina National College for Medical Studies, Jeddah, SAU.
Rahaf Abdulmohsen Masoud AlmuqatiCollege of Medicine, Ibn Sina National College for Medical Studies, Jeddah, SAU.
Hassan Mohammed H AlshahraniCollege of Medicine, Ibn Sina National College for Medical Studies, Jeddah, SAU.
Rakan Waleed MalDepartment of General Surgery, King Abdulaziz Hospital, Jeddah, SAU.
Waseel Naif Waseel AlrouqiCollege of Medicine, Ibn Sina National College for Medical Studies, Jeddah, SAU.
Ahmed Talal AlrefaiCollege of Medicine, Ibn Sina National College for Medical Studies, Jeddah, SAU.
Razan Mohammed H AlshahraniCollege of Medicine, Ibn Sina National College for Medical Studies, Jeddah, SAU.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Laparoscopic cholecystectomy (LC) has supplanted open cholecystectomy (OC) as the gold standard for gallbladder disease, but its adoption in older adults has remained inconsistent due to concerns about physiological reserve and operative risk. This review directly compares postoperative outcomes of LC versus OC exclusively within older adults (≥65 years). A systematic review and meta-analysis was conducted per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Five databases (PubMed/MEDLINE, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Scopus, and Web of Science Core Collection) were searched in January-February 2026 for comparative studies of LC versus OC in older adults published January 2000-February 2026. Risk of bias was assessed using the Newcastle-Ottawa Scale (NOS). Quantitative pooling of postoperative mortality was planned using a random-effects (DerSimonian-Laird) model where at least three studies reported adjusted, comparably defined estimates. Ten studies met the inclusion criteria, comprising 54,983 older adults (range: 94-47,500 per study). Two additional studies initially considered eligible were excluded after full-text review confirmed they lacked an extractable older adult-specific comparative subgroup. Of the 10 included studies, only two reported mortality estimates adjusted for confounding by indication; this fell short of the pre-specified three-study threshold for confirmatory quantitative pooling. Both adjusted estimates independently favored LC: the first study reported an adjusted OR for open surgery (relative to LC) of 5.4 (95% CI: 2.09-13.91), equivalent to an OR of 0.19 (95% CI: 0.07-0.48) for LC relative to OC, while the second study reported an adjusted OR of 0.16 (95% CI: 0.10-0.25) for LC relative to OC. As a post-hoc exploratory analysis, explicitly falling short of the pre-specified threshold and reported as a sensitivity check rather than a confirmatory result, random-effects pooling of these two adjusted estimates yielded an OR of 0.164 (95% CI: 0.109-0.249; p<0.0001) with no detectable heterogeneity (I²=0%). Unadjusted mortality counts reported in other studies (0.05% LC vs 1.55% OC, pre-matching) were not pooled with these adjusted estimates or with each other, given the high risk of confounding by indication inherent to crude comparisons in this literature. LC was also associated with shorter hospital stay, fewer postoperative complications, and lower readmission across the narratively synthesized outcomes. LC is associated with favorable postoperative outcomes compared with OC in older adults, including in octogenarian and nonagenarian subgroups, though the evidence base remains predominantly observational, quantitative pooling of mortality was not possible with the available data, and findings are subject to confounding by indication.

Indexed as

elderly patientslaparoscopic cholecystectomyopen cholecystectomypostoperative outcomessystematic review and meta-analysis

Identifiers

PMID42572550
PMCPMC13452965

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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.