Various approaches of laparoscopic common bile duct exploration plus primary duct closure for choledocholithiasis: A systematic review and meta-analysis

Common bile duct (CBD) stones may occur in up to 3%–14.7% of all patients with cholecystectomy. Various approaches of laparoscopic CBD exploration plus primary duct closure (PDC) are the most commonly used and the best methods to treat CBD stone. This systematic review was to compare the effectivene...

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Bibliographic Details
Published in:Hepatobiliary & pancreatic diseases international 2018-06, Vol.17 (3), p.183-191
Main Authors: He, Ming-Yan, Zhou, Xia-Dong, Chen, Hao, Zheng, Peng, Zhang, Fa-Zhan, Ren, Wei-Wei
Format: Article
Language:English
Subjects:
Biliary Tract Surgical Procedures - adverse effects
Biliary Tract Surgical Procedures - methods
Chi-Square Distribution
Choledocholithiasis
Choledocholithiasis - diagnostic imaging
Choledocholithiasis - surgery
Common Bile Duct - diagnostic imaging
Common Bile Duct - surgery
Common bile duct exploration
Device Removal
Drainage - instrumentation
Humans
Laparoscopy
Laparoscopy - adverse effects
Meta-analysis
Odds Ratio
Postoperative Complications - etiology
Primary duct closure
Risk Factors
Time Factors
Treatment Outcome
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Summary:Common bile duct (CBD) stones may occur in up to 3%–14.7% of all patients with cholecystectomy. Various approaches of laparoscopic CBD exploration plus primary duct closure (PDC) are the most commonly used and the best methods to treat CBD stone. This systematic review was to compare the effectiveness and safety of the various approaches of laparoscopic CBD exploration plus PDC for choledocholithiasis. Randomized controlled trials (RCTs) and non-randomized controlled trials (NRCTs) (case-control studies or cohort studies) were searched from Cochrane library (until Issue 2, 2015), Web of Science (1980-January 2016), PubMed (1966-January 2016), and Baidu search engine. After independent quality assessment and data extraction, meta-analysis was conducted using RevMan 5.1 software. Four RCTs and 18 NRCTs were included. When compared with choledochotomy exploration (CE) plus T-tube drainage (TTD) (CE + TTD), CE plus PDC (CE + PDC) and CE + PDC with biliary drainage (BD) (CE + PDC + BD) had a lower rate of postoperative biliary peritonitis (OR = 0.22; 95% CI: 0.06, 0.88; P 
ISSN:1499-3872
DOI:10.1016/j.hbpd.2018.03.009