文献检索文档翻译深度研究
Suppr Zotero 插件Zotero 插件
邀请有礼套餐&价格历史记录

新学期,新优惠

限时优惠:9月1日-9月22日

30天高级会员仅需29元

1天体验卡首发特惠仅需5.99元

了解详情
不再提醒
插件&应用
Suppr Zotero 插件Zotero 插件浏览器插件Mac 客户端Windows 客户端微信小程序
高级版
套餐订阅购买积分包
AI 工具
文献检索文档翻译深度研究
关于我们
关于 Suppr公司介绍联系我们用户协议隐私条款
关注我们

Suppr 超能文献

核心技术专利:CN118964589B侵权必究
粤ICP备2023148730 号-1Suppr @ 2025

等待胆囊切除术患者结石清除后胆道支架置入:系统评价与荟萃分析。

Biliary stent insertion after stone clearance in patients awaiting cholecystectomy: Systematic review and meta-analysis.

作者信息

Valvano Marco, Balducci Daniele, Vinci Antonio, Ghezzi Andrea, Djahandideh Shirin, Fabiani Stefano, Stefanelli Gianpiero, Buccilli Silvia, Montale Amedeo, Antonini Filippo, Maroni Luca, Campanale Chiara

机构信息

Department of Health Sciences, University of L'Aquila Department of Health Sciences, L'Aquila, Italy.

S.C. Gastroenterologia, Ente Ospedaliero Ospedali Galliera, Genova, Italy.

出版信息

Endosc Int Open. 2025 May 12;13:a25866007. doi: 10.1055/a-2586-6007. eCollection 2025.


DOI:10.1055/a-2586-6007
PMID:40376018
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12080521/
Abstract

BACKGROUND AND STUDY AIMS: Laparoscopic cholecystectomy is the standard treatment for patients with cholecystitis or gallbladder stones after common bile duct (CBD) clearance. According to the sequential strategy, cholecystectomy should be performed within 2 weeks after CDB clearance with endoscopic retrograde cholangiopancreatography (ERCP). However, in real-life experience, the average waiting time is 60 to 180 days. We aimed to evaluate the clinical rationale for prophylactic stent placement in CBD to prevent recurrent biliary events. PATIENTS AND METHODS: This systematic review and meta-analysis was performed following a protocol designed a priori (PROSPERO: CRD42024564804; July 13, 2024). All published studies involving patients who had undergone ERCP for CBDs and who were awaiting cholecystectomy were included. RESULTS: At the end of the revision process, four full texts including 755 patients were included in the meta-analysis. The odds ratio (OR) for symptom recurrence in patients awaiting cholecystectomy was 0.74 (95% confidence interval [CI] 0.30-1.79; I 67%). The pooled OR for adverse event occurrence was 0.74 (95% CI 0.45-1.24) in the stent group. The post-ERCP pancreatitis and cholangitis risk were 0.76 (95% CI 0.25-2.34) and 0.92 (95% CI 0.31-2.67), respectively. CONCLUSIONS: This meta-analysis showed no benefit for stent insertion after bile duct clearance in patients scheduled for delayed cholecystectomy. Further randomized controlled trials with bigger cohorts are needed to assess any benefit for this procedure, which in the meantime, cannot be recommended.

摘要

背景与研究目的:对于经胆总管(CBD)清理后患有胆囊炎或胆囊结石的患者,腹腔镜胆囊切除术是标准治疗方法。根据序贯策略,应在内镜逆行胰胆管造影术(ERCP)清理胆总管后2周内进行胆囊切除术。然而,在实际临床经验中,平均等待时间为60至180天。我们旨在评估在胆总管中预防性放置支架以预防复发性胆道事件的临床依据。 患者与方法:本系统评价和荟萃分析按照预先设计的方案进行(国际前瞻性系统评价注册库:CRD42024564804;2024年7月13日)。纳入所有已发表的涉及接受过胆总管ERCP且等待胆囊切除术患者的研究。 结果:在修订过程结束时,四项全文共755例患者纳入荟萃分析。等待胆囊切除术患者症状复发的比值比(OR)为0.74(95%置信区间[CI]0.30 - 1.79;I² 67%)。支架组不良事件发生的合并OR为0.74(95% CI 0.45 - 1.24)。ERCP后胰腺炎和胆管炎的风险分别为0.76(95% CI 0.25 - 2.34)和0.92(95% CI 0.31 - 2.67)。 结论:这项荟萃分析表明,对于计划进行延迟胆囊切除术的患者,胆总管清理后放置支架并无益处。需要进一步开展更大样本量的随机对照试验来评估该操作的任何益处,在此期间,不推荐使用此方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3765/12080521/5e49354fd174/10-1055-a-2586-6007_25904053.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3765/12080521/eb2f982c9a00/10-1055-a-2586-6007_25904051.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3765/12080521/53c70d57f086/10-1055-a-2586-6007_25904052.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3765/12080521/5e49354fd174/10-1055-a-2586-6007_25904053.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3765/12080521/eb2f982c9a00/10-1055-a-2586-6007_25904051.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3765/12080521/53c70d57f086/10-1055-a-2586-6007_25904052.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3765/12080521/5e49354fd174/10-1055-a-2586-6007_25904053.jpg

相似文献

[1]
Biliary stent insertion after stone clearance in patients awaiting cholecystectomy: Systematic review and meta-analysis.

Endosc Int Open. 2025-5-12

[2]
Prophylactic cholecystectomy offers best outcomes following ERCP clearance of common bile duct stones: a meta-analysis.

Eur J Trauma Emerg Surg. 2023-10

[3]
Surgical versus endoscopic treatment of bile duct stones.

Cochrane Database Syst Rev. 2013-12-12

[4]
Surgical versus endoscopic treatment of bile duct stones.

Cochrane Database Syst Rev. 2013-9-3

[5]
Laparoscopic common bile duct exploration plus cholecystectomy versus endoscopic retrograde cholangiopancreatography plus laparoscopic cholecystectomy for cholecystocholedocholithiasis: a meta-analysis.

Surg Endosc. 2018-12-3

[6]
One-Stage Intraoperative ERCP combined with Laparoscopic Cholecystectomy Versus Two-Stage Preoperative ERCP Followed by Laparoscopic Cholecystectomy in the Management of Gallbladder with Common Bile Duct Stones: A Meta-analysis.

Adv Ther. 2024-10

[7]
Surgical versus endoscopic treatment of bile duct stones.

Cochrane Database Syst Rev. 2006-4-19

[8]
Does prophylactic stent insertion to the common bile duct during endoscopic retrograde cholangiopancreatography (ERCP) before cholecystectomy have any impact on the rate of biliary complications?

Surg Endosc. 2013-7-17

[9]
Single-stage laparoscopic common bile duct exploration and cholecystectomy versus two-stage endoscopic stone extraction followed by laparoscopic cholecystectomy for patients with gallbladder stones with common bile duct stones: systematic review and meta-analysis of randomized trials with trial sequential analysis.

Surg Endosc. 2018-3-30

[10]
Comparison of laparoscopic common bile duct exploration plus cholecystectomy and endoscopic retrograde cholangiopancreatography followed by laparoscopic cholecystectomy for elderly patients with common bile duct stones and gallbladder stones.

J Gastrointest Surg. 2024-5

本文引用的文献

[1]
Prospective study on planned biliary stent placement to treat small common bile duct stones.

JGH Open. 2024-2-23

[2]
Role of Biliary Stenting After Stone Clearance in Patients Awaiting Cholecystectomy: The Jury Is Still Out!

Am J Gastroenterol. 2024-3-1

[3]
Endoscopic Gallbladder Stenting to Prevent Recurrent Cholecystitis in Deferred Cholecystectomy: A Randomized Trial.

Gastroenterology. 2024-6

[4]
Delay for cholecystectomy after common bile duct clearance with ERCP is just running after recurrent biliary event.

Surg Endosc. 2023-12

[5]
Role of Biliary Stent in Recurrence of Biliary Stones and Complications After Stone Clearance in Patients Awaiting Cholecystectomy: A Randomized Trial.

Am J Gastroenterol. 2023-10-1

[6]
Management of cholelithiasis with choledocholithiasis: Endoscopic and surgical approaches.

World J Gastroenterol. 2021-7-28

[7]
The PRISMA 2020 statement: an updated guideline for reporting systematic reviews.

BMJ. 2021-3-29

[8]
Efficacy of Common Bile Duct Stenting on the Reduction in Gallstone Migration and Symptoms Recurrence in Patients with Biliary Pancreatitis Who Were Candidates for Delayed Cholecystectomy.

Dig Dis Sci. 2022-1

[9]
Effect of stent placement on stone recurrence and post-procedural cholangitis after endoscopic removal of common bile duct stones.

Korean J Intern Med. 2021-3

[10]
Emergency general surgery in Italy during the COVID-19 outbreak: first survey from the real life.

World J Emerg Surg. 2020-5-24

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

推荐工具

医学文档翻译智能文献检索