ABSTRACT
Objective To compare the clinical effectivness of the treatment by open surgery and by therapeutic endoscopy for common bile duct(CBD) stones.Methods The randomised controlled trails on the open surgery or therapeutic endoscopy for CBD stones were identified by electronic-searching and hand-searching,meta-analysis was conducted using the methods recommended by the Cochrane Collaboration.Data of 407 patients included in 6 high-quality randomized controlled trials were meta-analyzed using in fixed effect model.Results Compared with endoscopic stone extraction technique,open surgery had retained stones after primary intervention rate(OR 0.39,95% CI 0.25 to 0.75,P=0.003) and additional procedures rate(OR 0.33,95% CI 0.19 to 0.60,P=0.0002) with statistical significance.But open surgery made no significant difference in postoperative complication rate(Peto OR 1.10,95% CI 0.69 to 1.76,P=0.67).Conclusion Current evidence suggests that there is no significant difference between open surgery and therapeutic endoscopy in preoperative complications,but open surgery is superior to therapeutic endoscopy in stone clearence rate.