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Laparoscopic Transcystic Common Bile Duct Exploration: Advantages over Laparoscopic Choledochotomy

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  • Qian Feng
  • Yong Huang
  • Kai Wang
  • Rongfa Yuan
  • Xiaoli Xiong
  • Linquan Wu

Abstract

Purpose: The ideal treatment for choledocholithiasis should be simple, readily available, reliable, minimally invasive and cost-effective for patients. We performed this study to compare the benefits and drawbacks of different laparoscopic approaches (transcystic and choledochotomy) for removal of common bile duct stones. Methods: A systematic search was implemented for relevant literature using Cochrane, PubMed, Ovid Medline, EMBASE and Wanfang databases. Both the fixed-effects and random-effects models were used to calculate the odds ratio (OR) or the mean difference (MD) with 95% confidence interval (CI) for this study. Results: The meta-analysis included 18 trials involving 2,782 patients. There were no statistically significant differences between laparoscopic choledochotomy for common bile duct exploration (LCCBDE) (n = 1,222) and laparoscopic transcystic common bile duct exploration (LTCBDE) (n = 1,560) regarding stone clearance (OR 0.73, 95% CI 0.50–1.07; P = 0.11), conversion to other procedures (OR 0.62, 95% CI 0.21–1.79; P = 0.38), total morbidity (OR 1.65, 95% CI 0.92–2.96; P = 0.09), operative time (MD 12.34, 95% CI −0.10–24.78; P = 0.05), and blood loss (MD 1.95, 95% CI −9.56–13.46; P = 0.74). However, the LTCBDE group showed significantly better results for biliary morbidity (OR 4.25, 95% CI 2.30–7.85; P

Suggested Citation

  • Qian Feng & Yong Huang & Kai Wang & Rongfa Yuan & Xiaoli Xiong & Linquan Wu, 2016. "Laparoscopic Transcystic Common Bile Duct Exploration: Advantages over Laparoscopic Choledochotomy," PLOS ONE, Public Library of Science, vol. 11(9), pages 1-13, September.
    • Handle: RePEc:plo:pone00:0162885
    DOI: 10.1371/journal.pone.0162885
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