Background and Aims: An agreement on whether three-dimensional (3D) or two-dimensional (2D) laparoscopic cholecystectomy is more beneficial for patients with benign gallbladder diseases has not been achieved so far and also, there are no large-scale multi-center studies on that available. This study was conducted to evaluated the clinical efficacy and safety of using 3D and 2D laparoscopy in cholecystectomy by Meta-analysis, so as to provide treatment options for benign gallbladder lesions. 
Methods: The Chinese and English databases were searched systematically, and the studies comparing the clinical efficacy of 3D and 2D laparoscopic cholecystectomy were screened according to the inclusion and exclusion criteria. The search time was up to March 2020. After the methodological quality evaluation and data extraction of the included studies, Meta-analysis was performed using RevMan 5.3 software.
Results: Finally, 11 studies were included, comprising 7 randomized controlled studies (RCT) and 4 retrospective studies, involving a total of 980 patients, with 438 cases in the 3D group and 542 cases in the 2D group. The results of Meta-analysis showed that in 3D group compared with the 2D group, the operative time (MD=–8.64, 95% CI= –12.87 –4.42, P=0.000 1) and intraoperative blood loss (MD=–13.82, 95% CI=-19.98 –7.65, P=0.000 1), and the incidence of intraoperative complications (OR=0.52, 95% CI=0.32 0.83, P=0.006) were significantly reduced; in overall analysis, the length of hospital stay in 3D group was shorter than that in 2D group (MD=–0.13, 95% CI=–0.25–0.02, P=0.02), but in subgroup analysis of RCT and retrospective studies, there was no statistical difference in the length of hospital stay between the two groups (MD=–0.12, 95% CI=–0.24 0.01, P=0.06; MD=–0.20, 95% CI=–0.45 0.05, P=0.12); there were no significant differences in terms of open conversion rates (OR=0.74, 95% CI=0.30 1.79, P=0.50) and the incidence rates of postoperative complications (OR=0.67, 95% CI=0.35 1.28, P=0.23) between the two groups.
Conclusion: The clinical efficacy and safety of 3D laparoscopy are better than those of 2D laparoscopy in cholecystectomy, which is worthy of clinical promotion and application. However, this conclusion still needs to be verified by large-scale multi-center, randomized, controlled studies.