Comparison of efficacy between choledochoscopic gallbladder-preserving cholelithotomy and laparoscopic cholecystectomy in treatment of gallstones: a meta-analysis
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摘要:
目的系统评价胆道镜保胆取石术(LRCP)与腹腔镜胆囊切除术(LC)在治疗胆囊结石中各自的优劣性。方法计算机检索中国生物医学文献数据库、中国知网、维普、万方数据库,及Pub Med、Embase、the Cochrane Library、Web of Science数据库中有关LRCP与LC治疗胆囊结石的随机对照试验(RCT),截止日期为2015年6月。对纳入的文献进行资料提取和质量评价,采用RevMan5.3软件进行Meta分析。结果共纳入5项RCT,总计685例患者。Meta分析结果显示,LRCL组与LC组在手术时间[比值比(OR)=8.85,95%可信区间(CI):0.4917.21,P=0.04]及术后腹泻发生率(OR=0.24,95%CI:0.110.53,P=0.000 4)方面差异具有统计学意义;而在术中出血量(OR=-12.37,95%CI:-29.734.99,P=0.16)、术后肠道功能恢复时间(OR=-7.19,95%CI:-24.289.90,P=0.41)、住院天数(OR=-...
Abstract:Objective To systematically evaluate the advantages and disadvantages of choledochoscopic gallbladder- preserving cholelithotomy( CGPC) and laparoscopic cholecystectomy( LC) in the treatment of gallstones. Methods The databases of CBM,CNKI,VIP,Wanfang Data,Pub Med,EMBASE,the Cochrane Library,and Web of Science were searched for randomized controlled trials( RCTs) related to CGPC and LC in the treatment of gallstones published up to June 2015. Data extraction and quality evaluation were performed for the literature included,and Review Manager 5. 3 was used for the meta- analysis. Results Five RCTs involving 685 patients were included. The results of the meta- analysis showed that CGPC group and LC group had significant differences in operation time( OR = 8. 85,95% CI:0. 49- 17. 21,P = 0. 04) and incidence of postoperative diarrhea( OR = 0. 24,95% CI: 0. 11- 0. 53,P = 0. 000 4). However,no significant differences were seen between the two groups in intraoperative bleeding volume( OR =- 12. 37,95% CI:- 29. 73- 4. 99,P = 0. 16),time to postoperative intestinal function recovery( OR =- 7. 19,95% CI:- 24. 28- 9. 90,P = 0. 41),hospitalization days( OR =- 0. 17,95% CI:- 1. 98- 1. 63,P = 0. 85),and hospital costs( OR =- 1. 14,95% CI:- 2. 57- 0. 28,P = 0. 12). Conclusion The operation time and incidence of postoperative diarrhea in CGPC are superior to those in LC,while no significant differences are observed in intraoperative bleeding volume,time to postoperative intestinal function recovery,hospitalization days,and hospital costs. Due to a limited number of articles included and publication bias,RCTs with a large sample size and high quality are needed to provide more effective data.
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Key words:
- cholecystolithiasis /
- choledochoscopy /
- cholecystectomy,laparoscopic /
- Meta-analysis /
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