胆总管切开探查术后一期缝合胆管的评价(附6个随机对照临床试验的meta分析)

Evaluation of clinical research for primary suture versus routine T-tube drainage for choledochostomy in open operation(a meta-analysis of 6 randomized trials).

目的 评价胆总管切开探查术后胆管一期缝合的临床效果。方法 采用固定或随机效应模型 ,对符合入选标准的 6篇RCT文献进行了meta分析。结果 与常规T管引流组相比 ,一期缝合胆管组在住院时间、术后近期并发症发生率上差异有显著性 (P =0 0 0 1和P =0 0 8) ,而在手术时间、手术死亡率和远期并发症发生率上则无显著差异性 (P =0 4,P=0 2 ,P=0 4)。结论 meta分析表明 ,和常规T管引流相比 ,胆总管切开探查术后选择性一期缝合胆管已安全可行 ,能缩短住院时间 ,降低术后各种近期并发症的发生率 ,不会延长手术时间。

Objective To evaluate randomized controlled trials(RCTs)of clinical research of primary suture after choledochotomy and provide scientific basis of sys tematic review of this clinical research.Methods 6 high quality articles of clinical controlled trials are obtained by electronic searching and hand searching.Data of 642 patients including in 6 high quality randomized trial were meta analyzed using in fixed or random effect model.Results Comparing with T tube drainage,primary suture decrease the chance of recent complications and shortens the post-operative staying time in hospital greatly,while not increase the mortality and operation time.Conclusion Comparing with T tube drainage,primary suture improves efficacy of operation in choledochostomy but does not add side effect,so it can be recommended for routine and safe use.