Can T-tube drainage be replaced by primary suture technique in laparoscopic common bile duct exploration? A meta-analysis of randomized controlled trials
| Autor: | Lan-Juan He, Yuan Deng, Hong-Wei Tian, Yan Zhang, Yun-Tao Ma, Yuan-Hui Gu |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Cochrane Library law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Humans Medicine Randomized Controlled Trials as Topic Common Bile Duct Common bile duct business.industry Suture Techniques Length of Stay Vascular surgery Surgery Cardiac surgery Choledocholithiasis medicine.anatomical_structure Cardiothoracic surgery 030220 oncology & carcinogenesis Meta-analysis Drainage Laparoscopy 030211 gastroenterology & hepatology business Abdominal surgery |
| Zdroj: | Langenbeck's Archives of Surgery. 405:1209-1217 |
| ISSN: | 1435-2451 1435-2443 |
| DOI: | 10.1007/s00423-020-02000-z |
| Popis: | Although laparoscopic common bile duct exploration (LCBDE) is considered the best treatment and has the advantages of being minimally invasive for common bile duct (CBD) stones, the choice of T-tube drainage (TTD) or primary duct closure (PDC) after LCBDE is still controversial. Therefore, the aim of the study was to compare the superiority of PDC versus TTD after LCBDE for choledocholithiasis. All potential studies which compare the surgical effects between PDC with TTD were electronically searched for in PubMed, Web of Science, and the Cochrane library databases up to November 2019. Data synthesis and statistical analysis were carried out using RevMan 5.3 software. In total, six randomized controlled trials with 604 patients (307 in the PDC group and 297 in the TTD group) were included in the current meta-analysis. As compared with the TTD group, the pooled data showed that PDC group had shorter operating time (WMD = −24.30; 95% CI = −27.02 to −21.59; p < 0.00001; I2 = 0%; p < 0.88), less medical expenditure (WMD = −2255.73; 95% CI = −3330.59 to −1180.86; p < 0.0001; I2 = 96%; p < 0.00001), shorter postoperative hospital stay (OR = −2.88; 95% CI = −3.22 to −2.54; p < 0.00001; I2 = 60%; p < 0.03), and lower postoperative complications (OR = 0.49; 95% CI = 0.31 to 0.78; p = 0.77; I2 = 0%; p = 0.003). There were no significant differences between the two groups concerning bile leakage (OR = 0.74; 95% CI = 0.36 to 1.53; p = 0.42; I2 = 0%; p = 0.90) and retained stones (OR = 0.96; 95% CI = 0.36 to 2.52; p < 0.93; I2 = 0%; p < 0.66). LCBDE with PDC should be performed as a priority alternative compared with TTD for choledocholithiasis. |
| Databáze: | OpenAIRE |
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