Table 1.
Meta-analyses of perioperative interventions to reduce the length of stay (LOS) or increase the day case rate in patients undergoing laparoscopic cholecystectomy
| Intervention | Outcome | Studies (n) | Participants (n) | Effect (95% CI)a | p value |
|---|---|---|---|---|---|
| Care pathway | LOS | 5 | 962 | 24.9 (18.7–31.2) | <0.001b |
| Care pathway | Day case rate | 6 | 2321 | OR 3.5 (1.5–8.1) | 0.005b |
| Carbohydrate supplement | LOS | 5 | 307 | 0.0 (−2.7 to 2.8) | 0.97 |
| Reduced pressure pneumoperitoneum | LOS | 6 | 1001 | 4.2 (−0.4 to 8.9) | 0.08 |
| Preoperative non-steroidal anti-inflammatory drugs | LOS | 6 | 447 | 1.7 (1.0–2.4) | <0.001b |
| Antiemetic | |||||
| Dexamethasone | LOS | 8 | 1053 | 1.4 (0.2–2.6) | 0.02b |
| Ondansetron | LOS | 6 | 395 | 0.8 (−0.1 to 1.7) | 0.08 |
| Antibiotics | LOS | 12 | 3410 | 0.6 (0.1–1.2) | 0.02b |
| Local anaesthesia (LA) | |||||
| Incisional LA | LOS | 4 | 382 | 9.4 (−5.0 to 23.8) | 0.2 |
| Intraperitoneal LA | LOS | 8 | 784 | 1.19 (−0.6 to 3.0) | 0.2 |
| Intraperitoneal LA | Day case rate | 4 | 308 | OR 1.8 (0.9–3.6) | 0.11 |
| Combined incisional and intraperitoneal LA | LOS | 5 | 360 | 2.7 (−0.1 to 5.5) | 0.06 |
| Drain insertion | LOS | 8 | 1629 | 11.97 (−1.5 to 25.5) | 0.08 |
a
Units of effect size for length of stay are reported as hours. Effect size for day case rate is reported as odds ratios (OR).
b
Indicates statistical significance.