Xu Ming, Tao You-Liang
Am Surg. 2019 Jan 1;85(1):86-91.
To conduct a randomized controlled trial (RCT), meta-analysis to assess the effectiveness of drains in reducing complications after laparoscopic cholecystectomy (LC) for acute cholecystitis needs to be carried out. An electronic search of PubMed, Embase, Science Citation Index, and the Cochrane Library from January 1990 to January 2018 was performed to identify randomized clinical trials that compare prophylactic drainage with no drainage in LC for acute cholecystitis. The outcomes were calculated as odds ratios (ORs) with 95 per cent confidence intervals (CIs) using RevMan 5.2. Four RCTs, which included 796 patients, were identified for analysis in our study. There was no statistically significant difference in the rate of morbidities (OR = 1.23, 95% CI 0.55-2.76, = 0.61). Abdominal pain was more severe in the drain group 24 hours after surgery (mean difference = 0.80, 95% CI 0.47-1.14; < 0.00001). No significant difference was present with respect to wound infection rate and hospital stay. The use of abdominal drainage does not appear to be of any benefit in patients having undergone early LC for acute cholecystitis.
为了进行一项随机对照试验（RCT），需要开展荟萃分析以评估引流在降低急性胆囊炎腹腔镜胆囊切除术（LC）后并发症方面的有效性。对1990年1月至2018年1月期间的PubMed、Embase、科学引文索引和考克兰图书馆进行了电子检索，以确定将急性胆囊炎LC中预防性引流与不引流进行比较的随机临床试验。使用RevMan 5.2将结果计算为具有95%置信区间（CI）的比值比（OR）。在我们的研究中，确定了四项包括796例患者的RCT用于分析。发病率方面无统计学显著差异（OR = 1.23，95%CI 0.55 - 2.76，P = 0.61）。术后24小时引流组的腹痛更严重（平均差值 = 0.80，95%CI 0.47 - 1.14；P < 0.00001）。伤口感染率和住院时间方面无显著差异。对于接受急性胆囊炎早期LC的患者，使用腹腔引流似乎并无任何益处。
