腹腔镜胆总管探查取石一期缝合疗效的荟萃分析

The therapeutic effects of primary suture after laparoscopic common bile duct exploration:a meta-analysis

目的：探讨腹腔镜胆总管探查取石一期缝合的疗效。方法：通过检索Pubmed、Medline数据库,对1990~2009年有关腹腔镜胆总管探查取石一期缝合（包括植入胆道支架一期缝合及直接一期缝合）与腹腔镜胆总管探查取石＂T＂管外引流病例的对照研究资料进行荟萃分析。结果：共纳入6篇文献,413例患者。分析结果显示,一期缝合组与＂T＂管外引流组相比,手术时间、术后总体并发症、术后胆道并发症的发生率两组差异均无统计学意义（P〉0.05）,但术后住院时间一期缝合组明显短于＂T＂管外引流组（P〈0.00001）。结论：腹腔镜胆总管探查取石一期缝合安全可行,疗效肯定,而且能明显减少术后住院时间。

Objective：To investigate the therapeutic effects of primary suture following laparoscopic common bile duct exploration.Methods：Meta-analysis was performed to access the effects of primary suture（including primary suture after implantation of biliary stent and directly primary suture） comparing with T-tube drainage following laparoscopic common bile duct exploration by a comprehensive Pubmed and Medline database retrieval from 1990 to 2009.Results：A total of 6 literatures involving 413 patients were retrieved for analysis.There was no significant difference in operating time,postoperatively total complication and biliary tract complications between the primary suture and T-tube drainage groups（P0.05）;Postoperative hospital stay was significantly shorter in the primary suture group than that in the T-tube drainage group（P0.00001）.Conclusions：The primary suture following laparoscopic common bile duct exploration is safe,feasible and effective,and it can significantly reduce postoperative hospital stay.