Meta-analysis of comparative clinical outcomes between primary closure and T-tube drainage following laparoscopic common bile duct exploration and extraction combined with cholecystectomy
Objective To systematically evaluate the comparative efficacy of primary closure versus T-tube drainage following laparoscopic common bile duct exploration (LCBDE) and extraction combined with cholecystectomy in the management of choledocholithiasis with concomitant cholecystolithiasis.Methods A com...
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Editorial Office of Journal of Surgery Concepts & Practice
2025-03-01
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| Series: | Waike lilun yu shijian |
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| Online Access: | https://www.qk.sjtu.edu.cn/jscp/fileup/1007-9610/PDF/1751876799475-1532618648.pdf |
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| author | WANG Ping, BAO Hui, SONG Zhenshun |
| author_facet | WANG Ping, BAO Hui, SONG Zhenshun |
| author_sort | WANG Ping, BAO Hui, SONG Zhenshun |
| collection | DOAJ |
| description | Objective To systematically evaluate the comparative efficacy of primary closure versus T-tube drainage following laparoscopic common bile duct exploration (LCBDE) and extraction combined with cholecystectomy in the management of choledocholithiasis with concomitant cholecystolithiasis.Methods A comprehensive search of databases including PubMed, CNKI, Wanfang, and VIP was conducted from January 1, 2012, to December 31, 2021. Eligible studies were screened based on predefined inclusion/exclusion criteria, and meta-analysis was performed using Review Manager 5.4 software.Results Ten studies involving 1 589 patients (783 primary closure vs. 806 T-tube drainage) were included. Meta-analysis demonstrated that primary closure significantly reduced operation time [MD = -15.59, 95% CI: (-23.74, -7.45), P = 0.000 2], intraoperative blood loss [MD = -6.49, 95% CI: (-12.74, -0.24), P = 0.04], postoperative gastrointestinal recovery time [MD = -0.39, 95% CI: (-0.60, -0.19), P= 0.000 2], postoperative hospital stay [MD = -1.41, 95% CI: (-2.19, -0.62), P = 0.000 4], and hospitalization costs [SMD = -0.66, 95% CI: (-1.21, -0.12), P = 0.02].Conclusions Both closure methods are safe and effective for choledocholithiasis with cholecystolithiasis. However, primary closure offers advantages including shorter operative duration, reduced blood loss, decreased hospital stay, and lower costs, warranting broader clinical adoption. |
| format | Article |
| id | doaj-art-bcdfec6741f7457bb81d1f4e911daebd |
| institution | Kabale University |
| issn | 1007-9610 |
| language | zho |
| publishDate | 2025-03-01 |
| publisher | Editorial Office of Journal of Surgery Concepts & Practice |
| record_format | Article |
| series | Waike lilun yu shijian |
| spelling | doaj-art-bcdfec6741f7457bb81d1f4e911daebd2025-08-20T03:33:27ZzhoEditorial Office of Journal of Surgery Concepts & PracticeWaike lilun yu shijian1007-96102025-03-0130215115810.16139/j.1007-9610.2025.02.10Meta-analysis of comparative clinical outcomes between primary closure and T-tube drainage following laparoscopic common bile duct exploration and extraction combined with cholecystectomyWANG Ping, BAO Hui, SONG Zhenshun01a. Department of Hepato-Biliary-Pancreatic Surgery, b. Department of Cardiovascular Medicine, Taizhou Fourth People's Hospital, Jiangsu Taizhou225300,China;2. Department of Hepatobiliary and Pancreatic Surgery, Shanghai Fourth People's Hospital affiliated to Tongji University, Shanghai 200434, ChinaObjective To systematically evaluate the comparative efficacy of primary closure versus T-tube drainage following laparoscopic common bile duct exploration (LCBDE) and extraction combined with cholecystectomy in the management of choledocholithiasis with concomitant cholecystolithiasis.Methods A comprehensive search of databases including PubMed, CNKI, Wanfang, and VIP was conducted from January 1, 2012, to December 31, 2021. Eligible studies were screened based on predefined inclusion/exclusion criteria, and meta-analysis was performed using Review Manager 5.4 software.Results Ten studies involving 1 589 patients (783 primary closure vs. 806 T-tube drainage) were included. Meta-analysis demonstrated that primary closure significantly reduced operation time [MD = -15.59, 95% CI: (-23.74, -7.45), P = 0.000 2], intraoperative blood loss [MD = -6.49, 95% CI: (-12.74, -0.24), P = 0.04], postoperative gastrointestinal recovery time [MD = -0.39, 95% CI: (-0.60, -0.19), P= 0.000 2], postoperative hospital stay [MD = -1.41, 95% CI: (-2.19, -0.62), P = 0.000 4], and hospitalization costs [SMD = -0.66, 95% CI: (-1.21, -0.12), P = 0.02].Conclusions Both closure methods are safe and effective for choledocholithiasis with cholecystolithiasis. However, primary closure offers advantages including shorter operative duration, reduced blood loss, decreased hospital stay, and lower costs, warranting broader clinical adoption.https://www.qk.sjtu.edu.cn/jscp/fileup/1007-9610/PDF/1751876799475-1532618648.pdf|common bile duct stone|laparoscopic common bile duct exploration(lcbde) and extraction|primary closure（pc）|t-tube drainage(td) |
| spellingShingle | WANG Ping, BAO Hui, SONG Zhenshun Meta-analysis of comparative clinical outcomes between primary closure and T-tube drainage following laparoscopic common bile duct exploration and extraction combined with cholecystectomy Waike lilun yu shijian |common bile duct stone|laparoscopic common bile duct exploration(lcbde) and extraction|primary closure（pc）|t-tube drainage(td) |
| title | Meta-analysis of comparative clinical outcomes between primary closure and T-tube drainage following laparoscopic common bile duct exploration and extraction combined with cholecystectomy |
| title_full | Meta-analysis of comparative clinical outcomes between primary closure and T-tube drainage following laparoscopic common bile duct exploration and extraction combined with cholecystectomy |
| title_fullStr | Meta-analysis of comparative clinical outcomes between primary closure and T-tube drainage following laparoscopic common bile duct exploration and extraction combined with cholecystectomy |
| title_full_unstemmed | Meta-analysis of comparative clinical outcomes between primary closure and T-tube drainage following laparoscopic common bile duct exploration and extraction combined with cholecystectomy |
| title_short | Meta-analysis of comparative clinical outcomes between primary closure and T-tube drainage following laparoscopic common bile duct exploration and extraction combined with cholecystectomy |
| title_sort | meta analysis of comparative clinical outcomes between primary closure and t tube drainage following laparoscopic common bile duct exploration and extraction combined with cholecystectomy |
| topic | |common bile duct stone|laparoscopic common bile duct exploration(lcbde) and extraction|primary closure（pc）|t-tube drainage(td) |
| url | https://www.qk.sjtu.edu.cn/jscp/fileup/1007-9610/PDF/1751876799475-1532618648.pdf |
| work_keys_str_mv | AT wangpingbaohuisongzhenshun metaanalysisofcomparativeclinicaloutcomesbetweenprimaryclosureandttubedrainagefollowinglaparoscopiccommonbileductexplorationandextractioncombinedwithcholecystectomy |