Postoperative pulmonary function in open versus laparoscopic cholecystectomy: A meta-analysis of the Tiffenau index

Background: Available scientific literature about open cholecystectomy ( OC) and laparoscopic cholecystectomy ( LC) does not show univocal results in terms of postoperative pulmonary function. A meta-analysis was carried out to evaluate the postoperative pulmonary function after OC and LC focusing on the Tiffenau index. Methods: Electronic databases were consulted ( Cochrane Library, Embase and Pubmed). Standardized mean difference ( SMD) with 95% CI was calculated for the Tiffenau Index. The kappa test was performed to evaluate agreement between the reviewers regarding the quality of the selected studies. A sensitivity analysis was carried out to assess the robustness of our study. Heterogeneity among studies was tested by using a chi(2) test at 0.05 significance level. A random effects model meta-analysis was performed. Results: Meta-analysis of the 13 articles included, resulted in a SMD of 53% ( 95% CI 0.04, 1.02) for the Tiffenau Index in favor of laparoscopic cholecystec tomy. The chi(2) test analysis showed the presence of heterogeneity among studies ( Tiffenau index chi(2) = 99.97, p = 0.03). The sensitivity analysis confirms the validity of our results. Conclusions: Postoperative pulmonary function is better preserved after laparoscopic cholecystectomy than open cholecystectomy. Copyright (C) 2008 S. Karger AG, Basel.