Meta-analysis of Laparoscopic Common Bile Duct Exploration and Endoscopic Retrograde Cholangiopancreatography Combined with Laparoscopic Cholecystectomy for Gallstones Complicated with Common Bile Duct Stones
FU Yan-wei,WANG Bao-ren,CHEN Chun-you
Department of Surgery,Tianjin Port Hospital, Tianjin 300456, China
Abstract:
Objective To objectively analyze the safety and effectiveness of laparoscopic and endoscopic treatment of gallbladder stones with common bile duct stone by evidence-based medicine. Methods The PubMed, Embase, Web of Science, Cochrane library and CNKI databases were searched by computer. The valid data was selected and compared using Review Manager 5.3 software. Results A total of 8 articles were included, with a total of 861 patients, including 433 in the LCBDE+LC group and 428 in the preoperative ERCP+LC group. Compared with preoperative ERCP+LC, the clearance rate of common bile duct stones in LCBDE+LC group was significantly increased (OR=1.83, 95% CI: 1.15~2.91, P<0.05). The postoperative bile leakage rate in LCBDE+LC group was significantly increased. High (OR=2.92, 95% CI: 1.39~6.15, P<0.05). The incidence of postoperative pancreatitis was significantly lower (OR=0.18, 95% CI: 0.06~0.50, P<0.05). Conclusion LCBDE+LC combined with preoperative ERCP+LC for the treatment of gallstones combined with common bile duct stones can effectively remove stones. The LCBDE+LC method has a low risk of recurrence, less postoperative complications and quick recovery after surgery.
