Comparison of the efficacy of LTCBDE and LCBDE for common bile duct stones: a systematic review and meta-analysis
BackgroundThe choice of surgical methods for common bile duct stones (CBDS) is controversial. The aim of this study was to compare the safety and efficacy of laparoscopic transcystic common bile duct exploration (LTCBDE) and laparoscopic common bile duct exploration (LCBDE).MethodsRelevant literatur...
Saved in:
Main Authors: | , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Frontiers Media S.A.
2025-01-01
|
Series: | Frontiers in Surgery |
Subjects: | |
Online Access: | https://www.frontiersin.org/articles/10.3389/fsurg.2024.1412334/full |
Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
_version_ | 1841555065287999488 |
---|---|
author | Bin Zheng Yixin Lu Erqi Li Ziyu Bai Kaiqian Zhang Jian Li Jian Li |
author_facet | Bin Zheng Yixin Lu Erqi Li Ziyu Bai Kaiqian Zhang Jian Li Jian Li |
author_sort | Bin Zheng |
collection | DOAJ |
description | BackgroundThe choice of surgical methods for common bile duct stones (CBDS) is controversial. The aim of this study was to compare the safety and efficacy of laparoscopic transcystic common bile duct exploration (LTCBDE) and laparoscopic common bile duct exploration (LCBDE).MethodsRelevant literature published before March 30, 2023 in PubMed, Web of Science, Embase, and Cochrane was searched to screen studies comparing LTCBDE and LCBDE. RevMan 5.4 was used for meta-analysis of fixed-effects and random-effects models.ResultsA total of 21 studies met the inclusion criteria, including 3065 patients in the LTCBDE group and 2,453 patients in the LCBDE group. CBDS clearance was 95.4% (2,682/2,812) in LTCBDE group and 94.7% (1,810/1,911) in LCBDE group (OR: 1.84, 95% CI: 1.36, 2.48, P < 0.0001; I2 = 0%, P = 0.56). In LTCBDE group, operative time(MD = −34.60, 95% CI: −46.05, −23, 15, P < 0.00001 I2 = 96%, P < 0.00001), postoperative hospital stay (MD = −2.92, 95% CI: −3.62, −2.21, P < 0.00001; I2 = 92%, P < 0.00001), postoperative complications (OR: 0.47, 95% CI: 0.38, 0.58, P < 0.0001; I2 = 26%, P = 0.15), residual stone(OR: 0.48, 95% CI: 0.34, 0.66, P < 0.0001; I2 = 0%, P = 0.56), bile leak (OR: 0.37, 95% CI: 0.25, 0.55, P < 0.00001; I2 = 0%,P = 0.52), mortality (OR: 0.10, 95% CI: 0.01, 0.88, P = 0.04; I2 = 0%, P = 0.71) and recurrent stones(OR: 0.34, 95% CI: 0.15, 0.74, P = 0.007; I2 = 5%, P = 0.38) were better than LCBDE group. There was no difference in pancreatitis (OR: 1.06, 95% CI: 0.52, 2.16. P = 0.86; I2 = 0%, P = 0.98) and biliary stricture(OR: 0.30, 95% CI: 0.08, 1.09, P = 0.07; I2 = 0%, P = 0.57).ConclusionsLTCBDE is safe, efficient, and of great clinical significance, and is worth promoting to some patients. |
format | Article |
id | doaj-art-20605b87922047199cc0dee39954a5b4 |
institution | Kabale University |
issn | 2296-875X |
language | English |
publishDate | 2025-01-01 |
publisher | Frontiers Media S.A. |
record_format | Article |
series | Frontiers in Surgery |
spelling | doaj-art-20605b87922047199cc0dee39954a5b42025-01-08T06:11:54ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2025-01-011110.3389/fsurg.2024.14123341412334Comparison of the efficacy of LTCBDE and LCBDE for common bile duct stones: a systematic review and meta-analysisBin Zheng0Yixin Lu1Erqi Li2Ziyu Bai3Kaiqian Zhang4Jian Li5Jian Li6Department of Hepatobiliary Surgery, Affiliated Hospital of Chengde Medical University, Chengde, Hebei Province, ChinaDepartment of Cardiovascular Medicine, Affiliated Hospital of Chengde Medical University, Chengde, Hebei Province, ChinaDepartment of Hepatobiliary Surgery, Affiliated Hospital of Chengde Medical University, Chengde, Hebei Province, ChinaDepartment of Hepatobiliary Surgery, Affiliated Hospital of Chengde Medical University, Chengde, Hebei Province, ChinaDepartment of Hepatobiliary Surgery, Affiliated Hospital of Chengde Medical University, Chengde, Hebei Province, ChinaDepartment of Hepatobiliary Surgery, Affiliated Hospital of Chengde Medical University, Chengde, Hebei Province, ChinaHebei Key Laboratory of Panvascular Diseases, Chengde, ChinaBackgroundThe choice of surgical methods for common bile duct stones (CBDS) is controversial. The aim of this study was to compare the safety and efficacy of laparoscopic transcystic common bile duct exploration (LTCBDE) and laparoscopic common bile duct exploration (LCBDE).MethodsRelevant literature published before March 30, 2023 in PubMed, Web of Science, Embase, and Cochrane was searched to screen studies comparing LTCBDE and LCBDE. RevMan 5.4 was used for meta-analysis of fixed-effects and random-effects models.ResultsA total of 21 studies met the inclusion criteria, including 3065 patients in the LTCBDE group and 2,453 patients in the LCBDE group. CBDS clearance was 95.4% (2,682/2,812) in LTCBDE group and 94.7% (1,810/1,911) in LCBDE group (OR: 1.84, 95% CI: 1.36, 2.48, P < 0.0001; I2 = 0%, P = 0.56). In LTCBDE group, operative time(MD = −34.60, 95% CI: −46.05, −23, 15, P < 0.00001 I2 = 96%, P < 0.00001), postoperative hospital stay (MD = −2.92, 95% CI: −3.62, −2.21, P < 0.00001; I2 = 92%, P < 0.00001), postoperative complications (OR: 0.47, 95% CI: 0.38, 0.58, P < 0.0001; I2 = 26%, P = 0.15), residual stone(OR: 0.48, 95% CI: 0.34, 0.66, P < 0.0001; I2 = 0%, P = 0.56), bile leak (OR: 0.37, 95% CI: 0.25, 0.55, P < 0.00001; I2 = 0%,P = 0.52), mortality (OR: 0.10, 95% CI: 0.01, 0.88, P = 0.04; I2 = 0%, P = 0.71) and recurrent stones(OR: 0.34, 95% CI: 0.15, 0.74, P = 0.007; I2 = 5%, P = 0.38) were better than LCBDE group. There was no difference in pancreatitis (OR: 1.06, 95% CI: 0.52, 2.16. P = 0.86; I2 = 0%, P = 0.98) and biliary stricture(OR: 0.30, 95% CI: 0.08, 1.09, P = 0.07; I2 = 0%, P = 0.57).ConclusionsLTCBDE is safe, efficient, and of great clinical significance, and is worth promoting to some patients.https://www.frontiersin.org/articles/10.3389/fsurg.2024.1412334/fullsurgeryLTCBDELCBDECBDSmeta-analysis |
spellingShingle | Bin Zheng Yixin Lu Erqi Li Ziyu Bai Kaiqian Zhang Jian Li Jian Li Comparison of the efficacy of LTCBDE and LCBDE for common bile duct stones: a systematic review and meta-analysis Frontiers in Surgery surgery LTCBDE LCBDE CBDS meta-analysis |
title | Comparison of the efficacy of LTCBDE and LCBDE for common bile duct stones: a systematic review and meta-analysis |
title_full | Comparison of the efficacy of LTCBDE and LCBDE for common bile duct stones: a systematic review and meta-analysis |
title_fullStr | Comparison of the efficacy of LTCBDE and LCBDE for common bile duct stones: a systematic review and meta-analysis |
title_full_unstemmed | Comparison of the efficacy of LTCBDE and LCBDE for common bile duct stones: a systematic review and meta-analysis |
title_short | Comparison of the efficacy of LTCBDE and LCBDE for common bile duct stones: a systematic review and meta-analysis |
title_sort | comparison of the efficacy of ltcbde and lcbde for common bile duct stones a systematic review and meta analysis |
topic | surgery LTCBDE LCBDE CBDS meta-analysis |
url | https://www.frontiersin.org/articles/10.3389/fsurg.2024.1412334/full |
work_keys_str_mv | AT binzheng comparisonoftheefficacyofltcbdeandlcbdeforcommonbileductstonesasystematicreviewandmetaanalysis AT yixinlu comparisonoftheefficacyofltcbdeandlcbdeforcommonbileductstonesasystematicreviewandmetaanalysis AT erqili comparisonoftheefficacyofltcbdeandlcbdeforcommonbileductstonesasystematicreviewandmetaanalysis AT ziyubai comparisonoftheefficacyofltcbdeandlcbdeforcommonbileductstonesasystematicreviewandmetaanalysis AT kaiqianzhang comparisonoftheefficacyofltcbdeandlcbdeforcommonbileductstonesasystematicreviewandmetaanalysis AT jianli comparisonoftheefficacyofltcbdeandlcbdeforcommonbileductstonesasystematicreviewandmetaanalysis AT jianli comparisonoftheefficacyofltcbdeandlcbdeforcommonbileductstonesasystematicreviewandmetaanalysis |