AB068. SOH25AB_041. Comparative outcomes of laparoscopic vs. robotic cholecystectomy: a meta-analysis of surgical efficacy and patient recovery

Background: Minimally invasive techniques, particularly laparoscopic cholecystectomy (LC) and robotic-assisted cholecystectomy (RAC), are now the mainstays in the surgical management of gallbladder diseases. Both techniques are in wide use, but there is a paucity of comparative studies with regards to surgical efficacy, cost, and patient recovery time. This meta-analysis aims to compare key differences between LC and RAC to improve clinical practice and outcomes.

Methods: We compared outcomes of LC and RAC in benign gallbladder disease by analyzing data from systematic reviews and meta-analyses of peer-reviewed studies. Metrics included operative time, complication rates, conversion rates, postoperative pain, length of stay, and cost-effectiveness. The analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines with a random-effects model used for the data synthesis.

Results: As compared to LC, RAC showed lower conversion rates (mean difference: 3.2%, P<0.05) with higher technical precision, mainly in difficult cases. However, RAC required longer operating times (mean difference: +20 minutes, P<0.01) and significantly higher costs as compared to LC. Postoperative pain and complication rates were comparable between the two modalities. Of note, patients undergoing RAC had a faster return to everyday activities (mean difference: 2 days, P<0.05), although LC proved to be more cost-effective and environmentally friendly.

Conclusions: Both LC and RAC proved to be safe and effective for the treatment of benign gallbladder diseases, with nuanced benefits depending on case complexity. RAC is preferred in technically challenging cases, while LC remains the gold standard in routine surgery. Future studies should focus on cost-effectiveness analysis, long-term patient outcomes, and sustainability to further tweak the clinical recommendations.

Keywords: Laparoscopic cholecystectomy (LC); robotic-assisted cholecystectomy (RAC); gallbladder surgery; minimally invasive surgery; surgical efficacy