文献类型：期刊文献

英文题名：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

作者：Lei, Caining[1,2,3];Lu, Tingting[3,4,5];Yang, Wenwen[2,6];Yang, Man[7];Tian, Hongwei[2,8];Song, Shaoming[2,6];Gong, Shiyi[2];Yang, Jia[2];Jiang, Wenjie[9];Yang, Kehu[3,4];Guo, Tiankang[1,2,8]

第一作者：Lei, Caining

通信作者：Guo, TK[1];Guo, TK[2];Yang, KH[3];Guo, TK[4]

机构：[1]Gansu Univ Chinese Med, Clin Med Coll 1, Lanzhou 730000, Peoples R China;[2]Gansu Prov Hosp, Dept Gen Surg, Lanzhou 730000, Peoples R China;[3]Lanzhou Univ, Sch Basic Med Sci, Evidence Based Med Ctr, Lanzhou 730000, Peoples R China;[4]Key Lab Evidence Based Med & Knowledge Translat G, Lanzhou 730000, Peoples R China;[5]Gansu Prov Hosp, Inst Clin Res & Evidence Based Med, Lanzhou 730000, Peoples R China;[6]Lanzhou Univ, Sch Clin Med 1, Lanzhou 730000, Peoples R China;[7]Univ Elect Sci & Technol China, Affiliated Canc Hosp, Sch Med, Chengdu 610000, Peoples R China;[8]Key Lab Surg Tumor Mol Diag & Precis Therapy Gans, Lanzhou 730000, Peoples R China;[9]Gansu Univ Chinese Med, Affiliated Hosp, Lanzhou 730000, Peoples R China

第一机构：甘肃中医药大学

通信机构：[1]corresponding author), Gansu Univ Chinese Med, Clin Med Coll 1, Lanzhou 730000, Peoples R China;[2]corresponding author), Gansu Prov Hosp, Dept Gen Surg, Lanzhou 730000, Peoples R China;[3]corresponding author), Lanzhou Univ, Sch Basic Med Sci, Evidence Based Med Ctr, Lanzhou 730000, Peoples R China;[4]corresponding author), Key Lab Surg Tumor Mol Diag & Precis Therapy Gans, Lanzhou 730000, Peoples R China.|[10735]甘肃中医药大学;

年份：2021

卷号：35

期号：11

起止页码：5918

外文期刊名：SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES

收录：;Scopus(收录号：2-s2.0-85111319002);WOS:【SCI-EXPANDED(收录号:WOS:000678415200003)】；

基金：This study was supported by the 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).

语种：英文

外文关键词：Gallstones; Common bile duct stones; Endoscopic retrograde cholangiopancreatography; Laparoscopic cholecystectomy; Laparoscopic common bile duct exploration

摘要：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.