Thirteen studies (five randomised controlled trials and eight cohort studies) were included in the review (n=680; 297 underwent open cholecystectomy and 383 underwent laparoscopic cholecystectomy). Sample sizes ranged from 20 to 118. The quality score in all studies ranged from 6 to 10 and was at least 8 in eight studies.
Compared with open cholecystectomy, laparoscopic cholecystectomy was associated with a significant improvement in postoperative pulmonary function relating to the Tiffenau Index (SMD 0.53, 95% CI 0.04 to 1.02; 13 studies). Significant heterogeneity was observed for this outcome (I2=88%).
Sensitivity analysis did not significantly alter the results. There was no evidence of publication bias.