胆囊切除术在高运动性胆道运动障碍中的作用：一项系统综述和荟萃分析

IF 1.4 Q3 SURGERY

Surgery open science Pub Date : 2025-06-01 DOI:10.1016/j.sopen.2025.06.001

Duyen Quach MD , Kayla Nguyen MD , Gabriella Tavera BS , Rachel Wright MD , Zuhair Ali MD , Mike Liang MD

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引用次数: 0

摘要

胆道运动障碍是一种以胆囊射血分数降低为特征的疾病，在胆囊切除术后表现出良好的反应。相比之下，以射血分数≥80%为定义的胆道运动障碍（hyperkinetic biliary dydyesia， HBD）是一种新兴现象，胆囊切除术的作用尚未明确定义。本文综述了胆囊切除术在缓解HBD症状方面的有效性。材料和方法根据预先确定的纳入标准进行全面的文献检索。数据由两位独立审稿人提取。meta分析采用随机效应模型。计算风险比（RR）来评估胆囊切除术对症状改善的影响。采用I2统计量和q检验计算异质性，并根据研究设计进行亚组分析。结果纳入14项研究，涉及416例HBD患者。总体而言，胆囊切除术后症状缓解的总RR为3.72 （95% CI: 2.57-5.38）。回顾性分析的亚组分析显示RR为3.9 （95% CI: 2.57-5.92）。观察到中度异质性（I2 = 30.01%）。结论根据现有证据，胆囊切除术似乎是一种有希望且有效的治疗HBD的方法。

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Role of cholecystectomy in hyperkinetic biliary dyskinesia: A systematic review and meta-analysis

Background

Biliary dyskinesia is disorder characterized by reduced gallbladder ejection fraction, which have shown a good response to cholecystectomy. In contrast, hyperkinetic biliary dyskinesia (HBD), as defined by ejection fraction ≥80 %, is an emerging phenomenon, and the role of cholecystectomy is not yet clearly defined. This review investigates the effectiveness of cholecystectomy in alleviating symptoms of HBD.

Material and methods

A comprehensive literature search was conducted to retrieve studies based on predefined inclusion criteria. Data were extracted by two-independent reviewers. A random-effects model was used for meta-analysis. Risk ratios (RR) were calculated to estimate the impact of cholecystectomy on symptom improvement. Heterogeneity was calculated using the I² statistic and Q-test, with subgroup analyses performed based on study design.

Results

Fourteen studies involving 416 patients with HBD were included. Overall, the pooled RR for symptom relief post-cholecystectomy was 3.72 (95 % CI: 2.57–5.38). A subgroup analysis of retrospective reviews showed an RR of 3.9 (95 % CI: 2.57–5.92). Moderate heterogeneity (I² = 30.01 %) was observed.