Complications in simultaneous laparoscopic cholecystectomy and laparoscopic hernia repair: A meta-analysis

Background: Surgeons concurrently perform laparoscopic cholecystectomies and hernia repairs. However, the potential complications of combining these procedures remain uncertain. Methods: We conducted a meta-analysis of observational studies following PRISMA guidelines. Utilizing random effect models, we assessed short- and long-term complications associated with simultaneous procedures. We included studies if they reported the sample size, data on the number of events, prevalence of mesh infection, surgical site infection, or any other complications reported by the authors. Both observational and experimental studies were identified through the PubMed, Embase, and Scopus databases. Heterogeneity was quantified using I² statistics, and R was employed for analysis. We assessed the risk of bias using the Cochrane risk of bias tool for randomized controlled trial (RCT), New Ottawa scale for observational studies, and JBI tool for case series. Results: Ten eligible records (n = 598 participants) were identified. Negligible rates of mesh or surgical site infections were observed. The pooled rates of seroma, recurrent hernia, and other complications were remarkably low (0.04 %, 0.08 %, and 0.03 %, respectively). Overall, the risk associated with simultaneous procedures was minimal. The quality of the included studies was good with some concerns for RCT and the average quality score for observational studies was 6.5. Discussion: Simultaneous laparoscopic cholecystectomy and hernia repair appear safe, with very low complication rates. This evidence supports the feasibility of combining these surgeries with minimal risk. However, owing to limited data on this topic, a few studies were included and majority of the studies were not randomized controlled trials; therefore, the issue of unmeasured confounding factors and the lack of a control group should be considered while interpreting the study findings.