What do systematic reviews say?

Open surgery vs ERCP

• Surgical versus endoscopic treatment of bile duct stones 2013 · Cochrane Headline outcomes only
  no estimate extracted
  8 studies · 733 participants
  Moderate

Open surgery vs ERCP

Open surgery showed no clear difference in total morbidity compared with ERCP (moderate certainty).

• Surgical versus endoscopic treatment of bile duct stones 2013 · Cochrane Headline outcomes only
  OR 1.12 [0.77, 1.62]
  8 studies · 729 participants
  Moderate

Open surgery vs ERCP

Open surgery probably leads to lower failure of procedure compared with ERCP (moderate certainty).

• Surgical versus endoscopic treatment of bile duct stones 2013 · Cochrane Headline outcomes only
  OR 0.32 [0.21, 0.48]
  7 studies · 943 participants
  Moderate

Open surgery vs ERCP

Open surgery probably leads to lower retained stones after primary intervention compared with ERCP (moderate certainty).

• Surgical versus endoscopic treatment of bile duct stones 2013 · Cochrane Headline outcomes only
  OR 0.36 [0.23, 0.57]
  7 studies · 943 participants
  Moderate

TACE followed by 3‐DCRT vs chemoembolisation

It is very uncertain whether TACE followed by 3‐DCRT changes non‐serious adverse events: leukopenia compared with TACE (very low certainty).

• Transcatheter arterial chemoembolisation followed by three‐dimensional conformal radiotherapy versus transcatheter… 2019 · Cochrane Headline outcomes only
  RR 1.12 [0.92, 1.34]
  5 studies · 438 participants
  Very low

Intervention not reported

It is very uncertain whether the intervention changes meropenem plus daptomycin (No direct RCT) (very low certainty).

• Antibiotic treatment for spontaneous bacterial peritonitis in people with decompensated liver cirrhosis: a network… 2019 · Cochrane Headline outcomes only
  HR 0.64 [0.05, 6.13]
  Studies not reported
  Very low

Gemcitabine plus mitomycin C vs capecitabine plus mitomycin C

It is very uncertain whether gemcitabine plus mitomycin C changes grade 1 ‐ 4 thrombocytopenia compared with capecitabine plus mitomycin C (very low certainty).

• Gemcitabine‐based chemotherapy for advanced biliary tract carcinomas 2018 · Cochrane Headline outcomes only
  RR 0.56 [0.29, 1.06]
  1 study · 47 participants
  Very low

Low‐pressure vs standard pressure pneumoperitoneum

It is very uncertain whether low pressure changes conversion to open cholecystectomy compared with standard pressure pneumoperitoneum (very low certainty).

• Low pressure versus standard pressure pneumoperitoneum in laparoscopic cholecystectomy 2014 · Cochrane Headline outcomes only
  RR 1.18 [0.29, 4.72]
  10 studies · 556 participants
  Very low

Fewer‐than‐four ports vs four ports

It is very uncertain whether fewer‐than‐four ports changes conversion to open cholecystectomy compared with four ports (very low certainty).

• Fewer‐than‐four ports versus four ports for laparoscopic cholecystectomy 2014 · Cochrane Headline outcomes only
  RR 0.68 [0.19, 2.35]
  5 studies · 581 participants
  Very low

LC + LCBDE vs LC + post‐operative ERCP

LC + LCBDE showed no clear difference in conversion to open surgery compared with LC + post‐operative ERCP (moderate certainty).

• Surgical versus endoscopic treatment of bile duct stones 2013 · Cochrane Headline outcomes only
  OR 1.77 [0.23, 13.81]
  2 studies · 166 participants
  Moderate

LC + LCBDE vs pre‐operative ERCP + LC

LC + LCBDE showed no clear difference in conversion to open surgery compared with pre‐operative ERCP + LC (moderate certainty).

• Surgical versus endoscopic treatment of bile duct stones 2013 · Cochrane Headline outcomes only
  OR 1.46 [0.76, 2.81]
  5 studies · 580 participants
  Moderate

Early vs delayed laparoscopic cholecystectomy

It is very uncertain whether early changes conversion to open cholecystectomy compared with delayed laparoscopic cholecystectomy (very low certainty).

• Early versus delayed laparoscopic cholecystectomy for people with acute cholecystitis 2013 · Cochrane Headline outcomes only
  RR 0.89 [0.63, 1.25]
  6 studies · 488 participants
  Very low

Intervention not reported

It is very uncertain whether the intervention changes conversion to open cholecystectomy (very low certainty).

• Abdominal lift for laparoscopic cholecystectomy 2013 · Cochrane Headline outcomes only
  RR 0.76 [0.26, 2.21]
  11 studies · 460 participants
  Very low

Miniport laparoscopic cholecystectomy vs standard port laparoscopic cholecystectomy

It is very uncertain whether miniport laparoscopic cholecystectomy changes conversion to open cholecystectomy compared with standard port laparoscopic cholecystectomy (very low certainty).

• Miniports versus standard ports for laparoscopic cholecystectomy 2013 · Cochrane Headline outcomes only
  RR 1.23 [0.44, 3.45]
  11 studies · 670 participants
  Very low

Early vs delayed laparoscopic cholecystectomy

It is very uncertain whether early changes conversion to open cholecystectomy compared with delayed laparoscopic cholecystectomy (very low certainty).

• Early versus delayed laparoscopic cholecystectomy for uncomplicated biliary colic 2013 · Cochrane Headline outcomes only
  RR 0.1 [0.01, 1.63]
  1 study · 63 participants
  Very low

Robotic assistant vs human assistant

It is very uncertain whether robotic assistant changes conversion to open cholecystectomy compared with human assistant (very low certainty).

• Robot assistant versus human or another robot assistant in patients undergoing laparoscopic cholecystectomy 2012 · Cochrane Headline outcomes only
  RR 0.9 [0.25, 3.2]
  2 studies · 133 participants
  Very low

T‐tube drainage vs primary closure

It is very uncertain whether T‐tube drainage changes peri‐operative mortality compared with primary closure (very low certainty).

• T‐tube drainage versus primary closure after open common bile duct exploration 2013 · Cochrane Headline outcomes only
  RR 2.25 [0.55, 9.25]
  6 studies · 359 participants
  Very low

T‐tube drainage vs primary closure

It is very uncertain whether T‐tube drainage changes serious morbidity (rate) compared with primary closure (very low certainty).

• T‐tube drainage versus primary closure after open common bile duct exploration 2013 · Cochrane Headline outcomes only
  Rate ratio 2.19 [0.98, 4.91]
  4 studies · 272 participants
  Very low
• T‐tube drainage versus primary closure after open common bile duct exploration 2013 · Cochrane Headline outcomes only
  RR 2.53 [0.29, 21.98]
  1 study · 35 participants
  Very low

T‐tube drainage vs primary closure

• T‐tube drainage versus primary closure after open common bile duct exploration 2013 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 40 participants
  Very low

T‐tube drainage vs primary closure

• T‐tube drainage versus primary closure after open common bile duct exploration 2013 · Cochrane Headline outcomes only
  no estimate extracted
  5 studies · 333 participants
  Very low