Single incision laparoscopic cholecystectomy is associated with a higher bile duct injury rate: a review and word of caution.
Single incision laparoscopic cholecystectomy is associated with a higher bile duct injury rate: a review and word of caution.
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单切口腹腔镜胆囊切除术与较高的胆管损伤率相关：回顾和警告。
DOI：
10.1097/sla.0000000000000555
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发表时间：
2015
影响因子：
9
通讯作者：
M. Grigg
中科院分区：
文献类型：
--
作者：
Sheryn Cheah;Steven Yuan;S. Mackay;M. Grigg
Joseph等人在他们的文章《单切口腹腔镜胆囊切除术与较高的胆管损伤率相关》一文中总结道：“与SLC中的历史发生率相比，SILC期间胆管损伤率似乎有所增加。”SILC指的是单切口腹腔镜胆囊切除术，而SLC指的是标准的腹腔镜胆囊切除术。不幸的是，他们的研究存在重大缺陷，这一结论不能合理地基于这项研究得出。作者对电子数据库进行了彻底的审查，适当地排除了数量非常少的论文，因为预计外科医生将处于学习曲线的陡峭部分。作者评论说，“Meta分析是不合适的，因为纳入的研究具有异质性，而且缺乏对照的比较分支”，这是一个非常合理的评论。然而，既然说荟萃分析是不可能的，那么作者就不合理地继续收集胆管损伤的数据，给出SILC胆管损伤率0.72%的单一汇总统计。披露：作者声明没有利益冲突。版权所有C 2014 Wolters Kluwer Health，Inc.保留所有权利。
In their article “Single Incision Laparoscopic Cholecystectomy Is Associated With a Higher Bile Duct Injury Rate,” Joseph et al1 conclude that “There seems to be an increase in the rate of bile duct injuries during SILC when compared with historic rates during SLC.” SILC refers to single incision laparoscopic cholecystectomy and SLC to standard laparoscopic cholecystectomy. Unfortunately, their study contains significant flaws, and this conclusion cannot reasonably be drawn on the basis of this piece of research. The authors performed a thorough review of electronic databases, and appropriately excluded papers with very small numbers, as the surgeons could be expected to be on the steep part of the learning curve. The authors comment that “Meta-analysis was not appropriate because of the heterogeneous nature of the included studies and the lack of a controlled comparative arm’” and this is a very reasonable comment. However, having stated that meta-analysis is not possible, it was unreasonable of the authors to then go ahead and pool the data for bile duct injuries to give the single summary statistic of a 0.72% rate of bile duct injury for SILC.Disclosure: The authors declare no conflicts of interest. Copyright C 2014 Wolters Kluwer Health, Inc. All rights reserved.