Endoscopic minimal invasive cholecystolithotomy vs laparoscopic cholecystectomy in treatment of cholecystolithiasis in China: A meta-analysis
Endoscopic minimal invasive cholecystolithotomy vs laparoscopic cholecystectomy in treatment of cholecystolithiasis in China: A meta-analysis
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内镜微创胆囊切开术与腹腔镜胆囊切除术治疗中国胆囊结石的荟萃分析
DOI：
10.1016/j.ijsu.2014.12.014
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发表时间：
2015-01-01
影响因子：
15.3
通讯作者：
Wang, GuoBin
中科院分区：
文献类型：
--
作者：
Ye, Lin;Liu, JiaNan;Wang, GuoBin
内镜下微创胆囊取石术（EMIC）最近在中国很流行，它可能比腹腔镜胆囊切除术（LC）有优势。我们试图找出胆囊结石患者最有利的治疗方法。方法：检索PubMed、Elsevier、Wiley Online Library、Cochrane Library、中国知网（CNKI）、万方数据（WanFang Data）、重庆维普（Chongqing VIP）等数据库，检索2009 - 2013年的随机对照试验（RCTs）和EMIC与LC的比较。以95%置信区间（CI）计算优势比（OR）、风险差（RD）和体重平均差（WMD）。结果：共纳入14项rct，共纳入2030例患者。在手术时间上，EMIC组与LC组无显著差异。与LC相比，EMIC的失血量显著减少（WMD -23.45; 95% CI -30.34, -16.55; Z = 6.66; P < 0.00001）。贫血组患者排气时间缩短（WMD -14.11; 95% CI -18.34, -9.88; Z = 6.53; P < 0.00001），住院时间缩短（WMD -1.31; 95% CI -1.91, -0.71; Z = 4.29; P < 0.00001）。与LC相比，EMIC组并发症比例降低（OR -0.14, 95% CI -0.09 ~ -0.21; Z = 8.53; P < 0.00001）。两种手术中结石的复发率没有差异，但与常规胆囊取石术相比，贫血症胆囊结石的复发率明显降低。结论：贫血患者恢复快，并发症少，优于LC。(C) 2014外科联合有限公司Elsevier Ltd.出版。版权所有。
Introduction: Endoscopic minimal invasive cholecystolithotomy (EMIC) is recently popular in China which may offer advantages over laparoscopic cholecystectomy (LC). We try to find out the most favorable treatment for the patients underwent cholecystolithiasis. Methods: Databases PubMed, Elsevier, Wiley Online Library, The Cochrane library, CNKI, WanFang Data, and Chongqing VIP were searched for randomized controlled trials (RCTs) and on EMIC vs LC from 2009 to 2013. Odds ratio (OR), risk difference (RD) and weight mean difference (WMD) were calculated with 95% confidence intervals (CI). Results: 14 RCTs including 2030 patients were selected. No significant difference was present in operating time between EMIC and LC. EMIC shown significant less blood lost (WMD -23.45; 95% CI -30.34, -16.55; Z = 6.66; P < 0.00001) compared to LC. Shortened exhaust time (WMD -14.11; 95% CI -18.34, -9.88; Z = 6.53; P < 0.00001) and hospital stay (WMD -1.31; 95% CI -1.91, -0.71; Z = 4.29; P < 0.00001) were present in EMIC group. And EMIC shown decreased complication proportion (OR -0.14, 95% CI -0.09 to -0.21; Z = 8.53; P < 0.00001) in comparison with LC. There is no difference present in the recurrence of stones in two procedures but a significantly decreased recurrence rate of gallstones was present in EMIC compared to conventional cholecystolithotomy. Conclusion: Patients treated with EMIC shown faster recovery and less complication which were superior to LC. (C) 2014 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.