腹腔镜胆总管探查一期缝合与胆道内支架引流一期缝合疗效比较的Meta分析OACSTPCD

Objective:Through meta-analysis,this study compared the clinical efficacy of laparoscopic common bile duct explo-ration(LCBDE)+primary suture(PS)with biliary drainage stenting(BDS)+PS and explored their clinical application value.Methods:The clinical studies comparing the efficacy of LCBDE+PS and LCBDE+BDS+PS in various databases at home and abroad were searched.The search period spanned from Jan.1,2010 to Aug.1,2023.Outcome indicators included operation time,duration of hospita-lization,incidence of postoperative bile leakage and overall complication rate.Relevant data were extracted and analyzed using RevMan 5.4 software.Results:Five retrospective cohort studies meeting the inclusion criteria were included,covering a sample size of 611 cases.There were 292 cases in the PS group,and 319 cases in the BDS+PS group.The results of the meta-analysis indicated no signifi-cant differences in operation time(WMD=-1.66,95%CI=-15.78～12.46,P=0.82),duration of hospitalization(WMD=-0.81,95%CI=-2.23～0.60,P=0.26),residual stone rate(OR=1.45,95%CI=0.24～8.83,P=0.69),and overall complication rate(OR=1.15,95%CI=0.70～1.88,P=0.58)between the two groups.However,the incidence of postoperative bile leakage(OR= 3.63,95%CI=1.77～7.44,P=0.0004)was higher in the PS group than that in the BDS+PS group.Conclusions:For choledocholi-thiasis patients who meet the indications,LCBDE+BDS+PS can reduce the incidence of postoperative bile leakage to a certain extent,which is safe and effective.