Abstract:
Objective Using meta-analysis to evaluate the clinical efficacy of Endoscopic Minimal Invasive Cholecystolithotomy (EMIC) and Laparoscopic Cholecystectomy (LC) in the treatment of gallstones.
Methods A comparative study of EMIC and LC for the treatment of gallstones in the Chinese biomedical literature database, China knowledge network, Vip, WanFang database, and PubMed , database from 2015 to 2020, a total of 9 literatures were included (1113 patients). Meta analysis was performed with stata15. The effectiveness and safety of the two methods were compared with 95% confidence interval (CI), calculated odds ratio (OR).
Results The results of meta-analysis showed that there was no significant difference in the time of operation [SMD=0.471(-0.154, 1.097)], the time of hospitalization [SMD=-0.341(-0.688, 0.007)], the incidence of postoperative complications [OR=0.531(0.247, 1.138)](P>0.05). However, the difference in the amount of intraoperative bleeding [SMD=-1.255(-2.152, -0.358)] and the time of postoperative gastrointestinal ventilation [SMD=-1.778(-3.059, -0.497)] was statistically significant(P<0.05), the cost of hospitalization in the EMIC group was higher than that in the LC group [SMD=0.232(0.043, 0.422)](P<0.05). The LC group was lower than the EMIC group in terms of the recurrence rate of postoperative stones [OR=3.513(1.031, 11.964)](P<0.05).
Conclusions Compared with LC, the EMIC in the treatment of gallstone has its unique advantages, mainly characterized by less intraoperative bleeding, patients with rapid recovery of gastrointestinal function. The cost of hospitalization and the recurrence rate of stones in EMIC group were higher than that in LC group. It is necessary to strictly control the surgical indications through more detailed and careful thinking about what kind of operation method to treat gallstones in clinic.
Key words:
Cholecystectomy, laparoscopic,
Meta-analysis,
Endoscopic minimal invasive cholecystolithotomy,
Comparative effectiveness research
Kai Zhong, Mutalifu Mureaihemaitijiang·, Fashun Lu, Xiaojie Zhen, Tiemin Jiang, Bo Ran, Qiang Guo, Ruiqing Zhang, Aji Tuerganaili·, Yingmei Shao. Endoscopic minimal invasive cholecystolithotomy and laparoscopic cholecystectomy for cholecystolithiasis: a meta-analysis[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2020, 14(05): 499-503.