Comparison On Two Minimally Invasive Procedures For Gallstones Combined With Common Bile Duct Stones:a Meta-analysis

Objective:Use meta analysis to compare the clinical effectivness of the management by laparoscopic bile duct exploration+laparoscopic cholecystectomy and by endoscopic retrograde cholangiopancreatography (ERCP/S)+laparoscopic cholecystectomy for cholecystolithiasis with common bile duct stones.Methods:Literatures of the randomised controlled trials on the management for cholecystolithiasis with common bile duct stones by laparoscopic bile duct exploration+LC and by endoscopic retrograde cholangiopancreatography (ERCP/S)+LC for this review were searched by electronic searching with databases of Cochrane PubMed, SCI, PUBMED, MEDLINE from databases establishment to January2012, The quality of the randomised controlled trials were evalued. Meta analysis was conducted using Cochrane Collaboration’s RevMan4.2software.Results:7randomised controlled trials(679patients) were induced. Meta analysis shows:Compared with ERCP/S, LCBDE had retained fewer stones after primary intervention rate [OR=1.98,95%CI(1.12,3.52), P=0.02] with statistical significance. But made no significant difference in conversion to open surgery [OR=1.07,95%CI (0.57,2.02), P=0.83] and postoperative complication rate [OR=1.04,95%CI (0.67,1.63), P=0.85]. Review shows that the length of hospital stay in the LCBDE group is shorter,and the cost is lower. Conclusion:Current evidence suggests that there is no significant difference between laparoscopic bile duct exploration+laparoscopic cholecystectomy and by endoscopic retrograde cholangiopancreatography (ERCP/S)+laparoscopic cholecystectomy in preoperative complications, but LCBDE is superior to therapeutic endoscopy in stone clearence rate.