Zachary Malaussena, Brody Smith, Ila Sethi, Paige DeBlieux, Rahul Mhaskar, Joseph Sujka, Christopher DuCoin, Salvatore Docimo
{"title":"一期经囊胆总管探查与二期ERCP加腹腔镜胆囊切除术治疗胆总管结石的疗效及并发症比较：系统综述和meta分析。","authors":"Zachary Malaussena, Brody Smith, Ila Sethi, Paige DeBlieux, Rahul Mhaskar, Joseph Sujka, Christopher DuCoin, Salvatore Docimo","doi":"10.1097/SLE.0000000000001364","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Early and effective management of choledocholithiasis is imperative to decrease patient morbidity. Despite the widespread use of ERCP, advancements in laparoscopy and choledochoscopy have renewed interest in laparoscopic CBD exploration (LCBDE). This meta-analysis compares outcomes of 2-stage ERCP followed by laparoscopic cholecystectomy (LC) versus one-stage transcystic LCBDE plus LC.</p><p><strong>Methods: </strong>A comprehensive literature search was performed in PubMed, CENTRAL, and Embase databases according to PRISMA guidelines. Studies were selected based on specific criteria. Data on stone clearance, postoperative pancreatitis, bleeding, mortality, and length of stay were extracted.</p><p><strong>Results: </strong>Seven comparative non-randomized studies enrolling 669 \"one-stage LCBDE patients\" and 724 \"two-stage ERCP patients\" were included. Overall, there were no statistically significant differences regarding the rates of stone clearance, pancreatitis, bleeding, and mortality between the 2 groups.</p><p><strong>Conclusion: </strong>One-stage transcystic LCBDE is noninferior to the 2-stage ERCP + LC approach, supporting its use as a first-line treatment for choledocholithiasis.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.1000,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Comparative Efficacy and Complications Between One-stage Transcystic Common Bile Duct Exploration and Two-stage ERCP Plus Laparoscopic Cholecystectomy for Treatment of Choledocholithiasis: A Systematic Review and Meta-analysis.\",\"authors\":\"Zachary Malaussena, Brody Smith, Ila Sethi, Paige DeBlieux, Rahul Mhaskar, Joseph Sujka, Christopher DuCoin, Salvatore Docimo\",\"doi\":\"10.1097/SLE.0000000000001364\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Early and effective management of choledocholithiasis is imperative to decrease patient morbidity. Despite the widespread use of ERCP, advancements in laparoscopy and choledochoscopy have renewed interest in laparoscopic CBD exploration (LCBDE). This meta-analysis compares outcomes of 2-stage ERCP followed by laparoscopic cholecystectomy (LC) versus one-stage transcystic LCBDE plus LC.</p><p><strong>Methods: </strong>A comprehensive literature search was performed in PubMed, CENTRAL, and Embase databases according to PRISMA guidelines. Studies were selected based on specific criteria. Data on stone clearance, postoperative pancreatitis, bleeding, mortality, and length of stay were extracted.</p><p><strong>Results: </strong>Seven comparative non-randomized studies enrolling 669 \\\"one-stage LCBDE patients\\\" and 724 \\\"two-stage ERCP patients\\\" were included. Overall, there were no statistically significant differences regarding the rates of stone clearance, pancreatitis, bleeding, and mortality between the 2 groups.</p><p><strong>Conclusion: </strong>One-stage transcystic LCBDE is noninferior to the 2-stage ERCP + LC approach, supporting its use as a first-line treatment for choledocholithiasis.</p>\",\"PeriodicalId\":22092,\"journal\":{\"name\":\"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.1000,\"publicationDate\":\"2025-03-31\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/SLE.0000000000001364\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/SLE.0000000000001364","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"SURGERY","Score":null,"Total":0}
Comparative Efficacy and Complications Between One-stage Transcystic Common Bile Duct Exploration and Two-stage ERCP Plus Laparoscopic Cholecystectomy for Treatment of Choledocholithiasis: A Systematic Review and Meta-analysis.
Background: Early and effective management of choledocholithiasis is imperative to decrease patient morbidity. Despite the widespread use of ERCP, advancements in laparoscopy and choledochoscopy have renewed interest in laparoscopic CBD exploration (LCBDE). This meta-analysis compares outcomes of 2-stage ERCP followed by laparoscopic cholecystectomy (LC) versus one-stage transcystic LCBDE plus LC.
Methods: A comprehensive literature search was performed in PubMed, CENTRAL, and Embase databases according to PRISMA guidelines. Studies were selected based on specific criteria. Data on stone clearance, postoperative pancreatitis, bleeding, mortality, and length of stay were extracted.
Results: Seven comparative non-randomized studies enrolling 669 "one-stage LCBDE patients" and 724 "two-stage ERCP patients" were included. Overall, there were no statistically significant differences regarding the rates of stone clearance, pancreatitis, bleeding, and mortality between the 2 groups.
Conclusion: One-stage transcystic LCBDE is noninferior to the 2-stage ERCP + LC approach, supporting its use as a first-line treatment for choledocholithiasis.
期刊介绍：
Surgical Laparoscopy Endoscopy & Percutaneous Techniques is a primary source for peer-reviewed, original articles on the newest techniques and applications in operative laparoscopy and endoscopy. Its Editorial Board includes many of the surgeons who pioneered the use of these revolutionary techniques. The journal provides complete, timely, accurate, practical coverage of laparoscopic and endoscopic techniques and procedures; current clinical and basic science research; preoperative and postoperative patient management; complications in laparoscopic and endoscopic surgery; and new developments in instrumentation and technology.
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