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Revista chilena de cirugía

versión On-line ISSN 0718-4026

Resumen

MANTEROLA, CARLOS; PINEDA, VIVIANA; VIAL, MANUEL  y  GRUPO MINCIR. Efficacy of Laparoscopy for treatment of cholecystolithiasis and common bile duct lithiasis. Rev Chil Cir [online]. 2007, vol.59, n.3, pp.198-207. ISSN 0718-4026.  http://dx.doi.org/10.4067/S0718-40262007000300006.

Introduction: Laparoscopy is the gold standard treatment for cholecystolithiasis. However its efficacy is not yet entirely known. The aim of this study is to evaluate the available evidence on the effectiveness of laparoscopic surgery for treating cholecystolithiasis and common bile duct lithiasis (CBDL). Material and Method: MEDLINE, EMBASE and The Cochrane Library databases were searched. All studies published between 1998 and 2006 were considered. Internal validity and global quality were assessed. Results: 80 studies were selected (9 systematic reviews, 19 clinical trials, 4 clinical practice guidelines, 15 cohort studies, 1 case and control studies and 32 case series). When compared with cholecystectomy, laparoscopic cholecystectomy (LC) is associated with less operating time, a shorter hospital stay and better quality of life, as it is a relatively safe procedure (high quality). Use of antibiotic prophylaxis results in no benefit in reducing infection rate in low-risk patients (hight quality). Despite the number of technological variants for performing a LC, their effectiveness is low and inconclusive. For treating CBDL, two-stage surgery is the most appropiate strategy for high-risk patients (high quality). Mortality is similar to open surgery as is effectiveness to endoscopio treatment (high quality). Conclusion: Recommendations are difficult given the lack of available evidence and the low methodological quality. Better quality studies assessing these techniques more adequately are warranted

Palabras clave : Cholecystolithiasis; Choledocholithiasis; Cholelithiasis; Gallstones; Laparoscopy; Cholecystectomy; Laparoscopic; Technology Assessment; Biomedical.

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