Postoperative complications of laparoscopic versus open common hepatic duct-jejunal Roux-en-Y anastomosis: a Meta-analysis
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摘要:
目的评价腹腔镜与开放肝总管空肠Roux-en-Y吻合术后并发症发生率。方法检索Pub Med、Web of Science、中国知网、维普、万方数据库,收集腹腔镜与开放肝总管空肠Roux-en-Y吻合术后并发症的相关研究,检索时限均为从建库至2016年5月20日,由2位研究者根据纳入与排除标准独立筛选文献、提取资料和评价质量,采用STATA12.0软件对术后总并发症、切口感染、黏连性肠梗阻和胆漏的发生率进行分析。结果纳入9篇文献共548例患者,腹腔镜组261例,开腹组287例。腹腔镜组与开腹组相比,总并发症发生率低[比值比(OR)=0.40,95%可信区间(95%CI):0.240.68),P=0.001],切口感染发生率低(OR=0.20,95%CI:0.080.53,P=0.001),黏连性肠梗阻发生率低(OR=0.25,95%CI:0.060.99,P=0.049),差异均有统计学意义;2组间胆漏发生率差异无统计学意义(P>0.05)。结论腹腔镜肝总管空肠Roux-en-Y吻合术较开放手术可降低术后总并发症、...
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关键词:
- 腹腔镜检查 /
- 吻合术,Roux-en-Y /
- 手术后并发症 /
- Meta分析
Abstract:Objective To investigate the incidence of postoperative complications in laparoscopic versus open common hepatic duct-jejunal Roux-en-Y anastomosis. Methods The databases of Pub Med,Web of Science,CNKI,VIP,and Wanfang Data were searched for related studies on postoperative complications in laparoscopic or open common hepatic duct-jejunal Roux-en-Y anastomosis published up to May 20,2016. Two reviewers performed literature screening according to inclusion and exclusion criteria,data extraction,and quality assessment independently. STATA12. 0 software was used for the meta-analysis. Results A total of 9 studies with 548 patients were enrolled. Among these patients,261 underwent laparoscopic surgery and 287 underwent open surgery. The results of the meta-analysis showed that compared with the open surgery group,the laparoscopic surgery group had lower incidence rates of total complications( OR =0. 40,95% CI: 0. 24-0. 68,P = 0. 001),incision infection( OR = 0. 20,95% CI: 0. 08-0. 53,P = 0. 001),and adhesive ileus( OR= 0. 25,95% CI: 0. 06-0. 99,P = 0. 049). However,there was no significant difference in the incidence of bile leakage between the two groups( P > 0. 05). Conclusion Compared with open surgery,laparoscopic common hepatic duct-jejunal Roux-en-Y anastomosis has a lower incidence of total postoperative complications,and therefore,it is a safe and feasible surgical procedure.
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Key words:
- laparoscopy /
- anastomosis /
- Roux-en-Y /
- postoperative complications
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