A Systematic Review and Meta-Analysis of Bag Extraction Versus Direct Extraction for Retrieval of Gallbladder After Laparoscopic Cholecystectomy

Abstract

This analysis aims to evaluate the comparative outcomes of gallbladder extraction with a bag versus direct extraction in laparoscopic cholecystectomy (LC). A systematic online search was conducted using the following databases: PubMed, Scopus, Cochrane database, The Virtual Health Library, Clinical trials.gov, and Science Direct. Comparative studies comparing bag versus direct extraction of the gallbladder in LC were included. Outcomes were surgical site infection (SSI), the extension of fascial defect to extract the gallbladder, intra-abdominal collection, bile spillage, and port-site hernia. Revman 5.4 (Cochrane, London, United Kingdom) was used for the data analysis. The results show eight studies were eligible to be included in this review with a total number of 1805 patients divided between endo-bag (n=835) and direct extraction (n=970). Four of the included studies were randomized controlled trials (RCTs) while the rest were observational studies. The rate of SSI and bile spillage were significantly higher in the direct extraction group: odds ratio (OR)=2.50, p=0.006 and OR=2.83, p=0.01, respectively. Comparable results were observed regarding intra-abdominal collection between the two groups(OR=0.01, p=0.51). However, the extension of a fascial defect was higher in the endo-bag group (OR=0.22, p=0.00001), and no difference was observed regarding the port-site hernia rate (OR-0.70, p=0.55). In conclusion, extraction of the gallbladder with an endo-bag provides a lower rate of SSI and bile spillage with similar results regarding post-operative intraabdominal collection. Although with the endo-bag, the fascial defect will more likely need to be increased to extract the gallbladder. However, the port-site hernia rate remains similar between the two groups.

Effect of topical antibiotics on the prevention and management of wound infections: A meta‐analysis

“…[36][37][38][39][40] However, the meta-analysis was unable to determine if differences in these variables are connected to the research results, properly led RCTs must take these factors into account in addition to the variety of diverse ages, genders and ethnicities of people. [41][42][43][44] In conclusion, TAs had significantly lower WI compared with placebo and antiseptics in people with UWs.…”

“…This was similarly emphasised in former research that utilised a connected meta‐analysis practice and originated comparable values of the impact 36–40 . However, the meta‐analysis was unable to determine if differences in these variables are connected to the research results, properly led RCTs must take these factors into account in addition to the variety of diverse ages, genders and ethnicities of people 41–44 . In conclusion, TAs had significantly lower WI compared with placebo and antiseptics in people with UWs.…”

Effect of retrieval bags in preventing surgical site wound infection during elective laparoscopic cholecystectomy in liver cancer patients: A meta‐analysis

“…More examination is still necessary to illuminate these possible impacts 30–36 . This was similarly emphasised in former research that utilised a connected meta‐analysis practice and originated comparable values of the impact 37–40 . Though the meta‐analysis was unable to determine if differences in these variables are connected to the research results, properly‐led RCTs must take these factors into account in addition to the diverse age groups, gender and ethnicities of patients 41 .…”

“…[30][31][32][33][34][35][36] This was similarly emphasised in former research that utilised a connected meta-analysis practice and originated comparable values of the impact. [37][38][39][40] Though the meta-analysis was unable to determine if differences in these variables are connected to the research results, properly-led RCTs must take these factors into account in addition to the diverse age groups, gender and ethnicities of patients. 41 In conclusion, RBs had significantly lower SSWI compared with controls during ELC in LC patients.…”

A comparative study on port-site infection following gall bladder retrieval using endobag and conventional method in laparoscopic cholecystectomy

“…It is still very unusual for LC patients to have their GBs perforated during surgery, either during dissection or specimen extraction, which increases the risk of surgical site infection (SSI). 1 Because it eliminates the organ that contributes to the production of gallstones and the difficulties that result from them, cholecystectomy is the preferred treatment for symptomatic gallstones. The most frequent laparoscopic procedure performed worldwide is LC, which has replaced open surgery as the standard gold treatment for symptomatic gallstones.…”