Wang Xuyun, Niu Xiangdong, Tao Pengxian, Zhang Yan, Su He, Wang Xiaopeng
General Surgery Cadre Ward, Gansu Provincial Hospital, Lanzhou, Gansu, 730000, China.
General Surgery Clinical Medical Center, Gansu Provincial Hospital, Lanzhou, Gansu, 730000, China.
Langenbecks Arch Surg. 2023 Mar 21;408(1):125. doi: 10.1007/s00423-023-02861-0.
To compare the efficacy and safety of laparoscopic cholecystectomy (LC) in the treatment of acute cholecystitis (AC) at different time points after percutaneous transhepatic gallbladder drainage (PTGBD).
PubMed, EMBASE, Cochrane Library, and Web of Science were searched from database inception to 1 May 2022. The last date of search was the May 30, 2022. The Newcastle-Ottawa scale (NOS) was used to conduct quality assessments, and RevMan (Version 5.4) was used to perform the meta-analysis.
A total of 12 studies and 4379 patients were analyzed. Compared with the < 2-week group, the ≥ 2-week group had shorter operation time, less intraoperative blood loss, shorter postoperative hospital stay, lower rate of conversion to laparotomy, and fewer complications. There was no statistical difference between the two groups regarding bile duct injury, bile leakage, and total cost.
The evidence indicates that the ≥ 2-week group has the advantage in less intraoperative blood loss, minor tissue damage, quick recovery, and sound healing in treating AC. It can be seen that LC after 2 weeks is safe and effective for AC patients who have already undergone PTGBD and is recommended, but further confirmation is needed in a larger sample of randomized controlled studies.
比较经皮经肝胆道引流（PTGBD）后不同时间点行腹腔镜胆囊切除术（LC）治疗急性胆囊炎（AC）的疗效和安全性。
检索PubMed、EMBASE、Cochrane图书馆和Web of Science数据库，检索时间从建库至2022年5月1日。最后检索日期为2022年5月30日。采用纽卡斯尔-渥太华量表（NOS）进行质量评估，并用RevMan（5.4版）进行荟萃分析。
共分析12项研究和4379例患者。与<2周组相比，≥2周组手术时间更短、术中出血量更少、术后住院时间更短、中转开腹率更低、并发症更少。两组在胆管损伤、胆漏和总成本方面无统计学差异。
证据表明，≥2周组在治疗AC时具有术中出血量少、组织损伤小、恢复快、愈合良好的优势。可见，2周后行LC对已行PTGBD的AC患者安全有效，推荐使用，但需要更大样本的随机对照研究进一步证实。
