A Meta Analysis Of Endoscopic Sphincterotomy Plus Laparoscopic Cholecystectomy For Concomitant Gallstones And Common Bile Duct Stones

Object: Our project here was to compare the safety and efficacy of laparoscopic cholecystectomy plus laparoscopic common bile duct stones exploration with LC plus endoscopic sphincterotomy treating patients with gallstones and CBD stones.Method: Cochrane Library,PubMed,CNKI,WANFAN DATA were searched to identify randomized controlled trails(RCTs)published before April 2018 comparing the LC+LCBDE and EST+LC in treating gallstone concomitant gallstones and common bile duct stones.Meta analysis was conducted by the RevMan 5.3.Results: A total of 10 RCTs involving 1374 patients were included in this meta-analysis.Meta analysis shows comparable effects between these two procedures in terms of CBD stone clear rate(RR=0.99,95%CI:0.94,1.04;P=0.56),conversion rate(RR=1.17,95%CI: 0.77,1.75;P=0.46),incidence of complications(RR=0.95,95%CI:0.72,1.25;P=0.71)and operative time(WMD=-8.90,95%CI:-38.00,20.21;P=0.55).LC+LCBDE has less length of hospital stay(WMD=-0.65,95%CI:-1.09,-0.22;P=0.003)and higher retained stones rate(RR=2.16,95%CI:1.25,3.73;P=0.006)than EST+LC.Conclusion: EST+LC has relatively good efficacy and safety in treatment of concomitant gallstone and common bile duct stones.