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ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 39 Issue 10
Oct.  2023
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Article Navigation >  Journal of Clinical Hepatology  > 2023  >  39(10): 2421-2431

Efficacy of laparoscopic choledochoscopy combined with holmium laser lithotripsy versus traditional laparotomy in treatment of bile duct stones： A Meta－analysis

DOI: 10.3969/j.issn.1001-5256.2023.10.021
  • 1.

    Department of General Surgery, （，Gansu Provincial Hospital，Lanzhou 730030，China）

  • 2.

    Department of Geriatric Medicine，Gansu Provincial Hospital，Lanzhou 730030，China）, （，Gansu Provincial Hospital，Lanzhou 730030，China

Research funding:

‍Gansu Provincial Hospital Key Research Project (17GSSY3－2);

Gansu Provincial Natural Science Foundation (20JR10RA381);

Gansu Provincial Hospital Youth Project (21GSSYC－17)

More Information
  • Corresponding author: WANG Xiaopeng， wxpjm78@163.com （ORCID： 0009－0002－3712－8975）; SU He， 13321217149@163.com （ORCID： 0009－0007－7481－5041）
  • Received Date: 2022-12-15
  • Accepted Date: 2023-03-09
  • Published Date: 2023-10-30
    Abstract
  •   Objective  To systematically review the efficacy and safety of laparoscopic choledochoscopy combined with holmium laser lithotripsy through a meta－analysis.  Methods  This study was conducted based on PRISMA guidelines， with a PROSPERO registration number of CRD42023406221. Chinese databases including CNKI， Wanfang Data， and VIP and foreign language databases such as PubMed， Embase， the Cochrane Library， and Web of Science were searched for original articles on traditional laparotomy versus laparoscopic choledochoscopy combined with holmium laser lithotripsy in the treatment of bile duct stones. Dichotomous variables were assessed by odds ratio （OR） and 95% confidence interval （CI）， while continuous variables were assessed by weighted mean difference （WMD） and 95%CI， and a sensitivity analysis was performed for outcome measures with relatively high heterogeneity. The Begg test and Egger test were used to evaluate publication bias. Stata 15.0 and Review Manager 5.3 were used to perform the statistical analysis.  Results  A total of 26 retrospective studies from China were included in this study， with 2 238 patients in total. The meta－analysis showed that compared with traditional laparotomy for the treatment of bile duct stones， laparoscopic choledochoscopy combined with holmium laser lithotripsy had significantly shorter time of operation （WMD＝－1.26， 95%CI： －1.36 to －1.16， P<0.001）， length of hospital stay （WMD＝－1.93， 95%CI： －2.64 to －1.12， P <0.001）， and time to bowel function recovery （WMD＝－1.52， 95%CI： －1.68 to －1.35， P<0.001）， significantly less intraoperative blood loss （WMD＝－1.79， 95%CI： －1.93 to －1.66， P<0.001）， a significantly lower rate of intraoperative residual stone （OR＝0.15， 95%CI： 0.11－0.20， P<0.001）， and significantly fewer complications （OR＝0.17， 95%CI： 0.13－0.23， P<0.001）.  Conclusion  Compared with traditional laparotomy， laparoscopic choledochoscopy combined with holmium laser lithotripsy shows better efficacy in the treatment of bile duct stones.

     

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