Summary of findings 2. Abdominal lift for laparoscopic cholecystectomy.
| Abdominal wall lift versus pneumoperitoneum for laparoscopic cholecystectomy | |||||
| Patient or population: patients with laparoscopic cholecystectomy. Settings: secondary or tertiary setting. Intervention: abdominal wall lift versus pneumoperitoneum. | |||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of participants (studies) | Quality of the evidence (GRADE) | |
| Assumed risk | Corresponding risk | ||||
| Pneumoperitoneum | Abdominal wall lift | ||||
| Serious adverse events (number of serious adverse events) | 20 per 1000 | 34.6 per 1000 (7 to 172) | Rate ratio 1.73 (0.35 to 8.61) | 198 (3 studies) | ⊕⊝⊝⊝ very low1,2,3,4 |
| Serious adverse events (proportion of patients with serious adverse events) | 12 per 1000 | 24 per 1000 (6 to 91) | RR 2.01 (0.52 to 7.80) | 343 (6 studies) | ⊕⊝⊝⊝ very low1,2,3,4 |
| Conversion to open cholecystectomy | 30 per 1000 | 23 per 1000 (8 to 66) | RR 0.76 (0.26 to 2.21) | 460 (11 studies) | ⊕⊝⊝⊝ very low1,2,3,4 |
| Operating time | The mean operating time in the control groups was 75 minutes | The mean operating time in the intervention groups was 6.87 higher (4.74 to 9.00 higher) | 649 (16 studies) | ⊕⊝⊝⊝ very low1,5 | |
| Proportion discharged as day‐patient laparoscopic cholecystectomy | 290 per 1000 | 485 per 1000 (247 to 946) | RR 1.67 (0.85 to 3.26) | 62 (2 studies) | ⊕⊝⊝⊝ very low1,2,3,4 |
| *The basis for the assumed risk is the mean control group risk across studies. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; RR: Risk ratio. | |||||
| GRADE Working Group grades of evidence High quality: further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: we are very uncertain about the estimate. | |||||
1 High risk of bias. 2 The confidence interval overlaps 1 and either 0.75 or 1.25. 3 There were fewer than 300 events in both groups. 4 Because of the few trials, we were unable to assess publication bias by funnel plot. However, this outcome was reported only in a small proportion of trials suggesting that there is evidence of selective reporting. 5 There was significant heterogeneity.