LC+LCBDE与EST+LC治疗继发性胆总管结石疗效的Meta分析  

A Meta Analysis on Curative Effects of LC+LCBDE Versus EST+LC for the Treatment of Secondary Common Bile Duct Stone

作　　者：蔡杰[1] 邬善敏[1] 李蔚[1] 陈辰[1] 温暖[1] 

机构地区：[1]武汉大学人民医院肝胆腔镜外科,湖北武汉430060

出　　处：《武汉大学学报（医学版）》2013年第1期90-94,共5页Medical Journal of Wuhan University

摘　　要：目的:比较腹腔镜胆囊切除术+经腹腔镜胆总管切开探查取石术(LC+LCBDE)与内镜下乳头括约肌切开取石术+腹腔镜胆囊切除术(EST+LC)两种微创治疗方案治疗继发性胆总管结石的临床效果。方法:计算机检索PubMed、CENTRAL、EMbase、重庆维普、中国知网、中国生物医学文献和万方数据库,查找所有比较LC+LCBDE与EST+LC治疗继发性胆总管结石疗效的RCT,检索时限均为2006年1月至2011年12月。按纳入排除标准由两人独立进行随机对照临床试验筛选、资料提取和质量评价后,按Cochrane协作网推荐的方法使用Rev-Man5.0软件进行Meta分析。结果:共纳入11例研究,共1799例患者。Meta分析结果显示:LC+LCBDE与EST+LC在手术成功率方面与手术并发症方面,差异无统计学意义。与EST+LC相比,LC+LCBDE手术总时间较短、术后住院时间较短、术后住院费用较低。结论:在患者自身和医疗条件都允许的情况下,LC+LCBDE比EST+LC更值得推荐。Objective： To systematically evaluate the difference between the therapeutic effects of laparoscopic cholecystectomy plus laparoscopic common bile duct exploration （LC＋LCBDE） and endoscopic sphincterotomy plus laparoscopic cholecystectomy （EST＋LC） for the treatment of second- ary common bile duct stone. Methods： The literature about the therapeutic effect of LC＋LCBDE and EST＋LC on secondary common bile duct stone were collected from PubMed, CENTRAL, EMbase, VIP, CNKI, CBM, and Wanfang Data for randomized controlled trials （RCTs） about LC＋LCBDE vs EST＋ LC for the treatment of secondary common bile duct stone. The time ranged from January 2006 to December 2011. Meta-analysis was conducted with RevMan5 software using the methods recommended by the Cochrane Collaboration. Results： Eleven studies and 1799 cases were included in the study. Meta-analysis showed there were no statistically significant differences between LC＋ LCBDE and EST ＋ LC in the success rate and in complications. Compared to that respectively of EST＋LC, total operation time, postoperative hospitalization time, and hospitalization cost of LC＋LCBDE is less. Conclusion： Rather than EST＋LC, LC＋ LCBDE is recommended economically for the patients with secondary common bile duct stone.

关 键 词：继发性胆总管结石 META分析 胆总管结石 胆囊结石 

分 类 号：R657.43[医药卫生—外科学]