Comparison of efficacy between choledochoscopic gallbladder-preserving cholelithotomy and laparoscopic cholecystectomy in treatment of gallstones: a meta-analysis / 临床肝胆病杂志

ABSTRACT

ObjectiveTo systematically evaluate the advantages and disadvantages of choledochoscopic gallbladder-preserving cholelithotomy (CGPC) and laparoscopic cholecystectomy (LC) in the treatment of gallstones. MethodsThe databases of CBM, CNKI, VIP, Wanfang Data, PubMed, EMBASE, the Cochrane Library, and Web of Science were searched for randomized controlled trials (RCTs) related to CGPC and LC in the treatment of gallstones published up to June 2015. Data extraction and quality evaluation were performed for the literature included, and Review Manager 5.3 was used for the meta-analysis. ResultsFive RCTs involving 685 patients were included. The results of the meta-analysis showed that CGPC group and LC group had significant differences in operation time (OR=8.85, 95% CI 049-17.21, P=0.04) and incidence of postoperative diarrhea (OR=0.24, 95% CI 0.11-0.53, P=0.000 4). However, no significant differences were seen between the two groups in intraoperative bleeding volume (OR=-12.37, 95% CI -29.73-4.99, P=016), time to postoperative intestinal function recovery (OR=-7.19, 95% CI -24.28-9.90, P=0.41), hospitalization days (OR=-0.17, 95% CI -1.98-1.63, P=0.85), and hospital costs (OR=-1.14, 95% CI -2.57-0.28, P=0.12). ConclusionThe operation time and incidence of postoperative diarrhea in CGPC are superior to those in LC, while no significant differences are observed in intraoperative bleeding volume, time to postoperative intestinal function recovery, hospitalization days, and hospital costs. Due to a limited number of articles included and publication bias, RCTs with a large sample size and high quality are needed to provide more effective data.