Comparison of intraoperative endoscopic retrograde cholangiopancreatography and laparoscopic common bile duct exploration combined with laparoscopic cholecystectomy for treating gallstones and common bile duct stones: a systematic review and meta-analysis
机构：[1]The First Clinical Medicine College, Gansu University of Chinese Medicine, Lanzhou 730000, China[2]Department of General Surgery, Gansu Provincial Hospital, Lanzhou 730000, China[3]Evidence‑Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China[4]Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou 730000, China[5]Institution of Clinical Research and Evidence Based Medicine, Gansu Provincial Hospital, Lanzhou 730000, China[6]The First School of Clinical Medicine, Lanzhou University, Lanzhou 730000, China[7]The Affiliated Cancer Hosptial School of Medicine, University of Electronic Science and Technology of China, Chengdu 610000, China四川省人民医院[8]Key Laboratory of Surgical Tumor Molecular Diagnosis and Precision Therapy in Gansu Province, Lanzhou 730000, China[9]Affiliated Hospital of Gansu University of Chinese Medicine, Lanzhou 730000, China
Background This study aimed to compare the efficacy and safety of laparoscopic cholecystectomy combined with intraoperative endoscopic retrograde cholangiopancreatography (LC-IntraERCP) and laparoscopic cholecystectomy combined with laparoscopic common bile duct exploration (LC-LCBDE) to determine which one-stage therapeutic strategy provides better outcomes for patients with gallstones and common bile duct stones. Methods Cochrane Library, EMBASE, PubMed, and Web of Science databases were searched to identify eligible articles from the database inception to September 2020. The revised Cochrane risk of bias tools for randomized trials (RoB-2) and non-randomized interventions (ROBINS-I) was used to assess the quality of the included studies. The overall quality of evidence was assessed through the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool. The primary outcomes consisted of surgical success, retained stones, and overall postoperative complications, while secondary outcomes included postoperative bleeding, postoperative pancreatitis, postoperative bile leakage, conversion to laparotomy, and operative time. Results Eight studies (four RCTs and four Non-RCTs with high quality) with 2948 patients were included. No significant difference was seen between the two groups regarding surgical success, overall postoperative complications, conversion to laparotomy, and operative time. The meta-analysis demonstrated that in the LC-IntraERCP group, the rate of retained stones (OR 0.51, 95% CI 0.28-0.91) and postoperative bile leakage were lower (OR 0.25, 95% CI 0.09-0.69), while in the LC-LCBDE group, postoperative bleeding (OR 5.24, 95% CI 1.65-16.65) and postoperative pancreatitis (OR 4.80, 95% CI 2.35-9.78) decreased. Conclusions LC-IntraERCP and LC-LCBDE exhibited similar efficacies when surgical success rate, overall postoperative complications, conversion to laparotomy, and operative time were compared. However, LC-IntraERCP is probably to be more effective in terms of lowering the rate of retained stones.
基金：
Key Laboratory of Molecular
Diagnostics and Precision Medicine for Surgical Oncology in Gansu
Province (Grant No. 2019GSZDSYS06), Gansu Province Science &
Technology support program of Science and Technology department
of Gansu Province (Grant No. 144FKCA073), and the Key Laboratory
of Evidence-Based Medicine and Knowledge Translation Foundation
of Gansu Province (Grant No. GSEBMKT-2021KFJJ001).
第一作者机构：[1]The First Clinical Medicine College, Gansu University of Chinese Medicine, Lanzhou 730000, China[2]Department of General Surgery, Gansu Provincial Hospital, Lanzhou 730000, China[3]Evidence‑Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China
共同第一作者：
通讯作者：
通讯机构：[1]The First Clinical Medicine College, Gansu University of Chinese Medicine, Lanzhou 730000, China[2]Department of General Surgery, Gansu Provincial Hospital, Lanzhou 730000, China[3]Evidence‑Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China[4]Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou 730000, China[8]Key Laboratory of Surgical Tumor Molecular Diagnosis and Precision Therapy in Gansu Province, Lanzhou 730000, China
推荐引用方式(GB/T 7714)：
Lei Caining,Lu Tingting,Yang Wenwen,et al.Comparison of intraoperative endoscopic retrograde cholangiopancreatography and laparoscopic common bile duct exploration combined with laparoscopic cholecystectomy for treating gallstones and common bile duct stones: a systematic review and meta-analysis[J].SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES.2021,35(11):5918-5935.doi:10.1007/s00464-021-08648-y.
APA：
Lei, Caining,Lu, Tingting,Yang, Wenwen,Yang, Man,Tian, Hongwei...&Guo, Tiankang.(2021).Comparison of intraoperative endoscopic retrograde cholangiopancreatography and laparoscopic common bile duct exploration combined with laparoscopic cholecystectomy for treating gallstones and common bile duct stones: a systematic review and meta-analysis.SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES,35,(11)
MLA：
Lei, Caining,et al."Comparison of intraoperative endoscopic retrograde cholangiopancreatography and laparoscopic common bile duct exploration combined with laparoscopic cholecystectomy for treating gallstones and common bile duct stones: a systematic review and meta-analysis".SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES 35..11(2021):5918-5935
医学