摘要
Abstract
Objective To systematically evaluate the comparative efficacy of primary closure versus T-tube drainage following laparoscopic common bile duct exploration(LCBDE)and extraction combined with cholecystectomy in the management of choledocholithiasis with concomitant cholecystolithiasis.Methods A comprehensive search of databases including PubMed,CNKI,Wanfang,and VIP was conducted from January 1,2012,to December 31,2021.Eligible studies were screened based on predefined inclusion/exclusion criteria,and meta-analysis was performed using Review Manager 5.4 software.Results Ten studies involving 1 589 patients(783 primary closure vs.806 T-tube drainage)were included.Meta-analysis demonstrated that primary closure significantly reduced operation time[MD=-15.59,95%CI:(-23.74,-7.45),P=0.000 2],intraoperative blood loss[MD=-6.49,95%CI:(-12.74,-0.24),P=0.04],postoperative gastrointestinal recovery time[MD=-0.39,95%CI:(-0.60,-0.19),P=0.000 2],postoperative hospital stay[MD=-1.41,95%CI:(-2.19,-0.62),P=0.000 4],and hospitalization costs[SMD=-0.66,95%CI:(-1.21,-0.12),P=0.02].Conclusions Both closure methods are safe and effective for choledocholithiasis with cholecystolithiasis.However,primary closure offers advantages including shorter operative duration,reduced blood loss,decreased hospital stay,and lower costs,warranting broader clinical adoption.关键词
胆总管结石/腹腔镜胆总管探查取石/一期缝合/T管引流Key words
Common bile duct stone/Laparoscopic common bile duct exploration(LCBDE)and extraction/Primary closure(PC)/T-tube drainage(TD)分类
医药卫生
