Nasobiliary Drainage Vs T Tube Drainage In Common Bile Duct Exploration——A Meta-Analysis

Objective Comparative analysing of common bile duct exploration by nasobiliary drainage with by T tube drainage.Method Selecting mainly large database Pubmed, ELSEVIER, Springlerlink, Wanfang, VIP, CBM, CNKI for literature retrieval. Screening for the literature about common bile duct exploration (including open surgery and laparoscopic surgery), nasobiliary drainage instead of T tube drainage (including preoperative and intraoperative) and randomized controlled trials and including them in the Meta-analysis. Compare the incidence of related complications and postoperative anal exhaust time, average hospitalization days, extubation time (pull out nasobiliary duct or T tube) and surgery time and so on.Result Through literature screening, seven randomized controlled trial,520cases (281of nasobiliary drainage group,239of T tube group) are included in the analysis. the incidence of postoperative bile leakage, wound infection and biliary complications of NBD (nasobiliary drainage) group instead of T tube drainage of common bile duct exploration was significantly lower than TTD (T tube drainage) group. Merged effect value RR respectively is0.30(95%CI,0.120.12),0.34(95%CI,0.150.15),0.29(95%CI,0.150.15). Anal exhaust time, average hospitalization days, extubation time of NBD group, are significantly earlier or shorter than those in TTD group. Merged effect value MD are respectively24.02h (95%CI34.52,34.52),8.83d (95%CI10.79,10.79),11.32d (95%CI14.95,14.95). However the surgery time of NBD group is11.03min(95%CI1.53,20.52) longer than TTD group and it is statistically significant.Conclusion Compared with traditional T tube drainage, nasobiliary drainage can reduce postoperative complications, shorten the extubation time and hospitalization days, relieve the suffering of the patients, but the risk of surgery time increases. On the premise of strictly grasp the indications, common bile duct exploration for application of nasal biliary drainage is a safe and reliable, and is better than the T tube drainage.