To systematically evaluate the safety and efficacy of ambulatory surgery outpatient laparoscopic cholecystectomy (OPLC).

Databases such as Clinical Trails, EMbase, Web of Science, PubMed, the Cochrane Library (Issue 2, 2018), Chinese National Knowledge Infrastructure, Chinese Biological Medical Database, Wanfang Database and VIP Chinese Science & Technology Journal Database from inception to February 2018 were searched to find out domestic and abroad published literature of OPLC. Two reviewers independently selected literatures, extracted data and assessed quality of the included studies. Meta-analysis was performed by using RevMan 5.3 software.

A total of twelve articles involving 5 232 patients with LC were included. Meta-analysis indicated that the OPLC group was more efficient than the inpatient laparoscopic cholecystectomy (IPLC) group in hospitalization expenses [SMD=-2.28, 95% CI (-3.33, -1.23), P<0.000 1], postoperative complications [OR=0.64, 95% CI (0.44, 0.93, P=0.02], the conversion to laparotomy rate [OR=0.31, 95% CI (0.15, 0.67), P=0.003], preoperative waiting time [SMD=-2.50, 95% CI (-4.15, -0.86), P=0.003], while with less advantage in health education satisfaction [OR=0.27, 95% CI (0.12, 0.65), P=0.003]. There were no statistically significant differences in overall satisfaction [OR=1.20, 95% CI (0.84, 1.71), P=0.33], readmission rate [OR=0.54, 95% CI (0.20, 1.50), P=0.24] or operation time [SMD= -0.22, 95% CI (-0.52, 0.08), P=0.16] between the two groups.

Compared with conventional surgery, OPLC can significantly shorten the preoperative waiting time, lower the hospitalization expenses, reduce the incidence of postoperative complications and the conversion rate to laparotomy, and does not increase the rate of readmission and surgical time, and drop the patient's health education satisfaction levels. Due to original data's limitation, our conclusion may have bias, and needs more high quality researches to verify.