Department of General Surgery, Soochow University Medical Center: Dushu Lake Hospital Affiliated to Soochow University, Soochow University, Suzhou, Jiangsu, China.
Department of Oncology, Soochow University Medical Center: Dushu Lake Hospital Affiliated to Soochow University, Soochow University, Suzhou, Jiangsu, China.
Turk J Gastroenterol. 2021 Nov;32(11):945-955. doi: 10.5152/tjg.2021.20578.
The purpose of this meta-analysis is to appraise the efficacy and safety of delayed laparoscopic cholecystectomy after percutaneous transhepatic gallbladder drainage (PTGBD) versus emergency laparoscopic cholecystectomy (ELC) for acute cholecystitis.
The kinds of literature were searched by Web of Science, PubMed, OVID, Cochrane Library, and EMBASE between the year 2000 and 2019. RevMan 5.3 was used for meta-analysis.
Seventeen studies with 2135 participants were included in our study. Compared with the ELC group, delayed laparoscopic cholecystectomy after percutaneous transhepatic gallbladder drainage group (PTGBD group) had a significant better effect in intraoperative bleeding (P = .002), conversion rate to open surgery (P = .02), postoperative complications (P < .00001), bile leakage (P = .01), bile duct injury (P = .02), and wound infection (P = .02). There was no significant difference between the two groups in operative time (P= 32), postoperative hospital stay (P = .30), and intraperitoneal hemorrhage (P = .39). PTGBD group had a significantly longer overall hospital stay than the ELC group (P < .00001).
Compared with the ELC group, the PTGBD group has several advantages, including bile duct injury, intraoperative bleeding, bile leakage, conversion rate to open surgery, postoperative complications, and wound infection. The only drawback in the PTGBD group is to lengthen the total hospital stay.
本荟萃分析旨在评估经皮经肝胆囊引流（PTGBD）后延迟腹腔镜胆囊切除术与急性胆囊炎急诊腹腔镜胆囊切除术（ELC）的疗效和安全性。
通过 Web of Science、PubMed、OVID、Cochrane 图书馆和 EMBASE 检索 2000 年至 2019 年的文献。使用 RevMan 5.3 进行荟萃分析。
本研究共纳入 17 项研究，2135 名参与者。与 ELC 组相比，PTGBD 组术中出血量（P=0.002）、中转开腹率（P=0.02）、术后并发症（P<0.00001）、胆漏（P=0.01）、胆管损伤（P=0.02）和切口感染（P=0.02）的效果显著更好。两组在手术时间（P=0.32）、术后住院时间（P=0.30）和腹腔内出血（P=0.39）方面无显著差异。PTGBD 组总住院时间明显长于 ELC 组（P<0.00001）。
与 ELC 组相比，PTGBD 组具有胆管损伤、术中出血、胆漏、中转开腹率、术后并发症和切口感染等优势。PTGBD 组唯一的缺点是延长了总住院时间。
