腹腔镜外科杂志2017，Vol.22Issue(12)：887-894,8.DOI:10.13499/j.cnki.fqjwkzz.2017.12.887
腹腔镜与开腹肝切除术治疗肝内胆管结石有效性及安全性的Meta分析
Efficacy and safety comparison of laparoscopic and open hepatectomy for hepatolithiasis:a meta-analysis
摘要
Abstract
Objective:To evaluate the efficacy and safety of laparoscopic hepatectomy ( LH) comparing with open hepatectomy ( OH) for hepatolithiasis. Methods:Literature retrieval was performed by searching PubMed,Embase,OVID and Cochrane library data-bases. After the effective data were extracted,meta analysis was carried out using RevMan 5. 3. The evaluated endpoints included opera-tive outcomes ( operating time,intraoperative blood loss and transfusion,initial stone clearance rate) and postoperative outcomes ( post-operative hospital stay,postoperative complications,final stone clearance rate,stone recurrence rate) . Results:Nine studies totaling 969 patients were included in the meta analysis,with 453 patients in the LH group and 516 patients in the OH group. LH was associated with significantly less intraoperative blood loss (WMD:-26. 18 ml,P=0. 02),lower intraoperative blood transfusion rate (OR:0. 38,P=0.005),fewer incidence of postoperative complications (OR:0. 57,P=0. 0007),and shorter postoperative hospital stay (WMD:-3. 29 d,P=0. 0001). But the operating time was longer compared with the OH group (WMD:23. 70 min,P=0. 04). No significant differences were found in the initial stone clearance rate (OR:1. 22,P=0. 43),final stone clearance rate (OR:2. 09,P=0. 21),stone recurrence rate (OR:0. 63,P=0. 21). Conclusions:LH is safe and effective for hepatolithiasis,and can reduce intraoperative blood loss,blood transfusion,postoperative complications and postoperative hospital stay,and accelerate postoperative recovery.关键词
肝内胆管结石/肝切除术/腹腔镜检查/剖腹术/Meta分析Key words
Hepatolithiasis/Hepatectomy/Laparoscopy/Laparotomy/Meta-analysis分类
医药卫生引用本文复制引用
雷焦,张如骐,杨小波,赵天明,章园..腹腔镜与开腹肝切除术治疗肝内胆管结石有效性及安全性的Meta分析[J].腹腔镜外科杂志,2017,22(12):887-894,8.基金项目
三峡大学学位论文培优基金资助项目(编号:2017YPY065) （编号:2017YPY065）
