早期与晚期腹腔镜胆囊切除术治疗急性胆囊炎有效性和安全性的评价

Evaluation of efficacy and safety of early and delayed laparoscopic cholecystectomy for acute cholecystitis

目的:评价早期与晚期腹腔镜胆囊切除术治疗急性胆囊炎的有效性和安全性。方法:计算机检索PubMed、EMbase、Cochrane数据库、中国生物医学文献数据库、中文科技期刊数据库,均从建库检索至2010年1月,并筛选已获文献的参考文献,纳入早期与晚期腹腔镜胆囊切除术的随机对照试验。由2名研究者独立进行质量评价和数据提取,采用RevMan5.0.2软件进行Meta分析。结果:共纳入5个随机对照试验,合计425例患者。Meta分析结果显示,两组间的并发症(RR=0.92,95%CI:0.44-1.92;P=0.83)和中转开腹率(RR=0.95,95%CI:0.60-1.50;P=0.82)差异无统计学意义。总住院时间早期组短于晚期组(MD=-3.35,95%CI:-4.03--2.67;P<0.01),差异有统计学意义。结论:早期腹腔镜胆囊切除术治疗急性胆囊炎安全有效,可缩短住院时间。

Objective：To evaluate the efficacy and safety of early and delayed laparoscopic cholecystectomy for acute cholecystitis.Methods：The data was searched in PubMed,EMbase,Cochrane,Chinese BioMedicine database and Chinese Science and Technology Periodical Database from established to Jan.2010,the references of the searched articles were screened for the randomized controlled trials of early and delayed laparoscopic cholecystectomy.Two independent investigators applied quality evaluation and data extraction.RevMan 5.0.2 was used for statistical analysis.Results：Five trials with 425 patients were included.According to the Meta analysis result,there was not significant difference between the two groups in complication （RR=0.92,95% CI：0.44-1.92;P=0.83） or the rate of conversion to open cholecystectomy （RR=0.95,95% CI：0.60-1.50;P=0.82）.However,the total hospital stay was 3 days shorter in the early group than delayed group （MD=-3.35,95% CI：-4.03--2.67;P0.01）.Conclusions：Early laparoscopic cholecystectomy for patients with acute cholecystitis appears safe and feasible,can shorten the hospital stay.