急性重症胆囊炎的腹腔镜胆囊切除术加或不加经皮经肝胆囊引流:荟萃分析

Q4 Medicine

中华肝胆外科杂志 Pub Date : 2019-12-28 DOI:10.3760/CMA.J.ISSN.1007-8118.2019.12.007

Z. Chong, Chen Sisi, Wang Minghui, Li Jisheng, Tian Xuechang

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引用次数: 0

摘要

目的比较腹腔镜胆囊切除术（LC）与经皮肝穿刺胆囊引流术（PTGD）治疗急性重症胆囊炎的疗效。方法根据预先确定的纳入和排除标准，选择23篇文章进行荟萃分析。所有患者均接受LC伴或不伴PTGD的治疗。采用荟萃分析法对其临床疗效进行分析。结果与LC相比，PTGD合并LC的各项手术指标均明显优于单纯LC（P均≤0.05），包括手术时间：95%可信区间（-27.24，-9.27）；术中失血：95%可信区间（-50.25，-40.19）；术后住院时间：95%可信区间（-3.63，-0.64）；转为开放腹部的比率：OR=0.48，95%CI（0.32，0.74）；切口感染率：OR=0.49，95%CI（0.25，0.99）；引流管留置时间：95%可信区间（-2.07，-1.19）；胃肠功能恢复时间：95%可信区间（-1.73，-0.77）；胆汁渗漏率：OR=0.23，95%CI（0.12，0.44）；并发症发生率：OR=0.36，95%CI（0.27,0.48）。关键词：胆囊炎，急性；腹腔镜胆囊切除术；治疗结果；经皮肝穿刺胆囊引流术；Meta分析

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Laparoscopic cholecystectomy with or without percutaneous transhepatic gallbladder drainage for acute severe cholecystitis:a meta-analysis

Objective To compare laparoscopic cholecystectomy (LC) with or without percutaneous transhepatic gallbladder drainage (PTGD) for acute severe cholecystitis. Methods According to the predefined inclusion and exclusion criteria, 23 articles were selected for this meta-analysis. All patients were treated with LC with or without PTGD. A meta-analysis was used to analyze the clinical efficacy. Results Compared with LC, all the surgical indicators of LC with PTGD were significantly better than LC alone (all P≤0.05), including the operation time: 95%CI(-27.24, -9.27); intraoperative blood loss: 95%CI(-50.25, -40.19); postoperative hospital stay: 95%CI(-3.63, -0.64); rates of conversion to open abdomen: OR=0.48, 95%CI(0.32, 0.74); rates of incision infection: OR=0.49, 95%CI(0.25, 0.99); drainage tube indwelling time: 95%CI(-2.07, -1.19); gastrointestinal function recovery time: 95%CI(-1.73, -0.77); rates of bile leakage: OR=0.23, 95%CI(0.12, 0.44); and rates of complications: OR=0.36, 95%CI(0.27, 0.48). Conclusion Compared with LC alone, PTGD+ LC is the preferred treatment for acute severe cholecystitis. Key words: Cholecystitis, acute; Cholecystectomy, laparoscopic; Treatment outcome; Percutaneous transhepatic gallbladder drainage; Meta-analysis

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来源期刊

中华肝胆外科杂志 Medicine-Gastroenterology

CiteScore

0.20

自引率

0.00%

发文量

7101

期刊介绍： Chinese Journal of Hepatobiliary Surgery is an academic journal organized by the Chinese Medical Association and supervised by the China Association for Science and Technology, founded in 1995. The journal has the following columns: review, hot spotlight, academic thinking, thesis, experimental research, short thesis, case report, synthesis, etc. The journal has been recognized by Beida Journal (Chinese Journal of Humanities and Social Sciences). Chinese Journal of Hepatobiliary Surgery has been included in famous databases such as Peking University Journal (Chinese Journal of Humanities and Social Sciences), CSCD Source Journals of China Science Citation Database (with Extended Version) and so on, and it is one of the national key academic journals under the supervision of China Association for Science and Technology.