文献类型：期刊文献

英文题名：Can T-tube drainage be replaced by primary suture technique in laparoscopic common bile duct exploration? A meta-analysis of randomized controlled trials

作者：Deng, Yuan[1];Tian, Hong-Wei[1];He, Lan-Juan[2,3];Zhang, Yan[1];Gu, Yuan-Hui[1];Ma, Yun-Tao[1]

第一作者：Deng, Yuan

通信作者：Ma, YT[1]

机构：[1]Gansu Prov Hosp, Lanzhou, Peoples R China;[2]Gansu Univ Chinese Med, Lanzhou, Peoples R China;[3]Res Ctr Tradit Chinese Med, Lanzhou, Gansu, Peoples R China

第一机构：Gansu Prov Hosp, Lanzhou, Peoples R China

通信机构：[1]corresponding author), Gansu Prov Hosp, Lanzhou, Peoples R China.

年份：2020

卷号：405

期号：8

起止页码：1209

外文期刊名：LANGENBECKS ARCHIVES OF SURGERY

收录：;Scopus(收录号：2-s2.0-85091798201);WOS:【SCI-EXPANDED(收录号:WOS:000574353100001)】；

语种：英文

外文关键词：Laparoscopic common bile duct exploration; Primary duct closure; T-tube drainage; Meta-analysis

摘要：Background Although laparoscopic common bile duct exploration (LCBDE) is considered the best treatment and has the advantages of being minimally invasive for common bile duct (CBD) stones, the choice of T-tube drainage (TTD) or primary duct closure (PDC) after LCBDE is still controversial. Therefore, the aim of the study was to compare the superiority of PDC versus TTD after LCBDE for choledocholithiasis. Methods All potential studies which compare the surgical effects between PDC with TTD were electronically searched for in PubMed, Web of Science, and the Cochrane library databases up to November 2019. Data synthesis and statistical analysis were carried out using RevMan 5.3 software. Results In total, six randomized controlled trials with 604 patients (307 in the PDC group and 297 in the TTD group) were included in the current meta-analysis. As compared with the TTD group, the pooled data showed that PDC group had shorter operating time (WMD = -24.30; 95% CI = -27.02 to -21.59;p< 0.00001;I-2= 0%;p< 0.88), less medical expenditure (WMD = -2255.73; 95% CI = -3330.59 to -1180.86;p< 0.0001;I-2= 96%;p< 0.00001), shorter postoperative hospital stay (OR = -2.88; 95% CI = -3.22 to -2.54;p< 0.00001;I-2= 60%;p< 0.03), and lower postoperative complications (OR = 0.49; 95% CI = 0.31 to 0.78;p= 0.77;I-2= 0%;p= 0.003). There were no significant differences between the two groups concerning bile leakage (OR = 0.74; 95% CI = 0.36 to 1.53;p =0.42;I-2= 0%;p =0.90) and retained stones (OR = 0.96; 95% CI = 0.36 to 2.52;p< 0.93;I-2= 0%;p< 0.66). Conclusions LCBDE with PDC should be performed as a priority alternative compared with TTD for choledocholithiasis.