Efficacy comparison of biliary drainage stenting and T-tube drainage after laparoscopic common bile duct exploration: a Meta-analysis
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Department of General Surgery, the 904th Hospital of Joint Logistic Support Force of PLA, Wuxi, Jiangsu 214000, China

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R657.4

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    Abstract:

    Background and Aims Laparoscopic common bile duct exploration (LCBDE) is the most commonly used surgical procedure for the treatment of common bile duct stones, but the methods for suture of the common bile duct after LCBDE remain controversial. Biliary drainage stenting (BDS) is a suture technique of the common bile duct and has been widely used in recent years. Compared with the traditional T-tube drainage, BDS has the advantages of primary closure and avoidance of the long-term placement of T-tube after surgery. Therefore, this study was conducted to evaluate the clinical application value of BDS by comparing the clinical efficacy of BDS and T-tube drainage following LCBDE through a Meta-analysis.Methods The clinical studies comparing BDS and T-tube drainage following LCBDE were collected by searching several national and international literature databases. The retrieval time was set from January 1, 2010 to January 1, 2022. The outcome variables included operative time, blood loss, time to anal gas passage, time to abdominal drainage tube removal, length of hospitalization and incidence rates of bile leakage and overall complications. Meta-analysis was performed using Revman 5.4 software.Results A total of 11 studies meeting the inclusion criteria were selected, including 5 randomized controlled trials and 6 retrospective cohort studies, involving 1 140 patients, with 561 cases in BDS group and 579 cases in T-tube drainage group. The results of Meta-analyses showed that there was no significant difference in operative time (WMD=-4.60, 95% CI=-10.01-0.81, P=0.10) and blood loss (WMD=-0.66, 95% CI=-2.12-0.79, P=0.37) between the two groups, but BDS group was superior to control group in terms of time to postoperative gas passage (WMD=-8.99, 95% CI=-13.60--4.39, P=0.000 1), incidence rates of bile leakage (OR=0.37, 95% CI=0.17-0.78, P=0.009) and overall complications (OR=0.41, 95% CI=0.23-0.73, P=0.002), time to abdominal drainage tube removal (WMD=-1.33, 95% CI=-2.47--0.19, P=0.02) and length of hospital stay (WMD=-3.79, 95% CI=-5.24- -2.35, P<0.000 01).Conclusion For indicated patients with common bile duct stones, BDS suture after LCBDE can accelerate the postoperative recovery and reduce the complications associated with suture of the common bile duct. So, it is a safe procedure with certain clinical application value.

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XU Jian, HE Xiangkun, SUN Chao, YU Feng. Efficacy comparison of biliary drainage stenting and T-tube drainage after laparoscopic common bile duct exploration: a Meta-analysis[J]. Chin J Gen Surg,2023,32(2):161-170.
DOI:10.7659/j. issn.1005-6947.2023.02.001

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History
  • Received:July 15,2022
  • Revised:January 15,2023
  • Adopted:
  • Online: March 02,2023
  • Published: