To investigate the clinical efficacy and safety of laparoscopic surgery in the treatment of hepatic cystic echinococcosis.

Literatures published from January 1992 to November 2017 were retrieved in database of PubMed, Cochrane Library and Wanfang data, etc. The searching keywords included hepatic cystic echinococcosis, echinococcosis, surgery, laparoscope, minimally invasive surgery, living or hepatic, open, laparoscopic or minimal invasive in both Chinese and English. Clinical data related to therapeutic effect, complications, length of hospital stay and recurrence rate were extracted for Meta-analysis from the included literatures.

A total of 8 articles were eligible including 6 retrospective case-control studies and 2 prospective studies. A total of 1 075 cases were recruited including 238 cases in laparoscopic surgery group and 837 in open surgery group. In laparoscopic surgery group, the incidence of postoperative complications was significantly lower (OR=0.58, 95%CI: 0.38-0.87, P<0.05), the incidence of incision-related complications was significantly lower (OR=0.34, 95%CI: 0.13-0.91, P<0.05) and the length of hospital stay was significantly shorter (MD=-3.61, 95%CI: -4.84 to -2.38, P<0.05) compared with those in open surgery group. No significant difference was observed in the incidence of postoperative bile leakage, residual cavity infection, hydrops and recurrence rate between two groups (OR=0.87, 0.51, 0.50; P>0.05).

Laparoscopic surgery is safe for cystic echinococcosis, it can achieve the same effect as open surgery. Compared with open surgery, laparoscopic surgery has the advantages of lower incidence of postoperative incision-related complications and shorter length of hospital stay.

Echinococcosis, hepatic; Laparoscopes; Surgical procedures, operative; Comparative effectiveness research; Perioperative care