Effects and Safety of Laparoscopic Cholecystectomy and Open Cholecystectomy for Chronic Atrophic Cholecystitis:A Meta-Analysis of RCTs_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 HEXue-wen ¹ , WANGWen-hui ¹ ,  CHAIChen ²

1. Department of Interventional Radiology Combined with Traditional Chinese and Western Medicine, The First Affiliated Hospital of Lanzhou University, Lanzhou 730000, Gansu Province, China;
2. DepartmentⅠ of General Surgery, The First Affiliated Hospital of Lanzhou University, Lanzhou 730000, Gansu Province, China;

Corresponding author：

HEXue-wen, Email: hxw112082@hotmail.com; CHAIChen, Email: chasechai@126.com

Keywords：

Chronic atrophic cholecystitis; Laparoscope; Laparotomy; Meta-analysis

DOI：

10.7507/1007-9424.20140202

Video：

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Objective To systematically evaluation the efficacy and safety of laparoscopic cholecystectomy(LC) and open cholecystectomy(OC) for chronic atrophic cholecystitis. Methods Standard electronic database such as PubMed, Web of science, Cochrane library, CNKI, VIP, CBM, and Wanfang database were searched to retrieve relevant randomized controlled trials(RCTs) that comparing LC with OC, which were analyzed systematically using RevMan5.2. Results Seven RCTs including 758 patients were brought into this Meta analysis. There were significant differences between two groups regarding operative time(MD=-27.70, 95% CI:-44.25--11.16, P=0.001), amount of blood loss during operation(MD=-113.25, 95% CI:-141.68--84.81, P < 0.000 01), the recovery time of gastrointestinal function(MD=-28.49, 95% CI:-29.80--27.18, P < 0.000 01), and length of hospital stay(MD=-3.83, 95% CI:-6.01--1.65, P=0.000 6), There were statistically significant difference in utilization rate of anodynes after operation(MD=0.12, 95% CI:0.06-0.23, P < 0.000 1) and terrible postoperative complications(MD=0.24, 95% CI:0.12-0.47, P < 0.000 01) between LC and OC. Conclusions In both efficacy and safety, LC for chronic atrophic cholecystitis are significantly superior than the traditional OC. But now the clinical randomized controlled trials about LC is less and the quality is poor, so that its long-term safety evaluation still needs large sample quality RCTs to be further verified.

Citation： HEXue-wen, WANGWen-hui, CHAIChen. Effects and Safety of Laparoscopic Cholecystectomy and Open Cholecystectomy for Chronic Atrophic Cholecystitis:A Meta-Analysis of RCTs. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2014, 21(7): 855-861. doi: 10.7507/1007-9424.20140202 Copy

1.	周钱江, 王跃东, 竺杨文, 等.慢性萎缩性胆囊炎腹腔镜切除术95例临床分析[J].肝胆胰外科杂志, 2008, 20(4):288-289.
2.	陈广泰.腹腔镜胆囊切除术治疗慢性萎缩性胆囊炎临床分析[J].中外医疗, 2010, 29(32):92.
3.	廉世松, 杨吉田, 彭玲霞.沅陵县农村居民胆囊结石的调查分析[J].中国民康医学, 2011, 23(3):336-337.
4.	谭宜将, 刘衍民.胆囊结石发病原因研究现状与进展[J].中国实用外科杂志, 2009, 29(7):602-603, 606.
5.	史建中, 万焕真.腹腔镜胆囊切除术在老年急性胆囊炎患者中的应用探讨[J].中国普通外科杂志, 2011, 20(8):895-897.
6.	胡三元.腹腔镜临床诊治技术[M].济南:山东科学技术出版社, 2002:77.
7.	Giger U, Michel JM, Vonlanthen R, et al. Laparoscopic cholecystectomy in acute cholecystitis:indication, technique, risk and outcome[J]. Langenbecks Arch Surg, 2005, 390(5):373-380.
8.	王和曹, 余鹏.腹腔镜胆囊切除术治疗急性胆囊炎46例分析[J].肝胆胰外科杂志, 2009, 21(1):74-75.
9.	Higgins JPT GSe. Cochrane Handbook for Systematic Reviews of Interventions Version 5. 1. 0[DB/OL]. Available from http://www.cochrane.org/handbook.
10.	Jadad AR, Moore RA, Carroll D, et al. Assessing the quality of reports of randomized clinical trials:is blinding necessary?[J]. Control Clin Trials, 1996, 17(1):1-12.
11.	余辉.腹腔镜胆囊切除术对慢性萎缩性胆囊炎的疗效分析[J].中国民族民间医药, 2012, 21(24):79.
12.	贾丹.腹腔镜手术治疗慢性萎缩性胆囊炎80例的效果分析[J].中国医学创新, 2013, 10(24):117-118.
13.	张县强.腹腔镜手术治疗慢性萎缩性胆囊炎的临床效果分析[J].中国医药科学, 2012, 2(8):166-167.
14.	吴伟, 余育晖.腹腔镜与传统开腹手术治疗慢性萎缩性胆囊炎的临床疗效对照研究[J].中国普通外科杂志, 2013, 22(8): 1090-1092.
15.	薛应祥, 黄健.腹腔镜与开腹胆囊摘除术的效果比较[J].西部医学, 2011, 23(3):509-510.
16.	张坤, 所广军, 陈铜兵.腹腔镜与开腹手术治疗慢性萎缩性胆囊炎的疗效比较[J].北方药学, 2012, 9(12):51.
17.	王昌松, 罗洪, 赵少勇.腹腔镜与开腹手术治疗慢性萎缩性胆囊炎的临床疗效比较[J].航空航天医药, 2010, 21(7):1143-1144.
18.	何振兴, 马海, 杨红春, 等.年轻医师腹腔镜胆囊切除术的学习曲线探讨[J].中国普外基础与临床杂志, 2013, 20(11): 1284-1286.
19.	夏永红.腹腔镜胆囊切除术和开腹胆囊切除术后并发症发生率的比较[J].中国普通外科杂志, 2012, 21(8):1010-1012.
20.	葛长青, 李全福, 刘建辉, 等.腹腔镜辅助胆道镜保胆取石术与腹腔镜胆囊切除术的比较[J].中国内镜杂志, 2012, 18(2): 199-202.
21.	卢茂松, 刘强, 黄征焘.电视腹腔镜胆囊切除术及小切口开腹胆囊切除术的临床比较[J].现代预防医学, 2011, 38(2): 380-381.
22.	梁治升, 崔清枫, 勾承月.慢性萎缩性胆囊炎的腹腔镜治疗[J].中国医药导报, 2009, 6(16):55-56.
23.	吴碧胜, 向建军.腹腔镜和传统开腹胆囊切除术对患者肠道黏膜通透性影响的比较[J].中国普通外科杂志, 2013, 22(4): 532-535.
24.	汪卫平.腹腔镜与开腹手术治疗慢性萎缩性胆囊炎的临床疗效比较[J].中外医学研究, 2011, 9(26):34-35.
25.	梁治升, 崔清枫, 勾承月.腹腔镜与开腹手术治疗慢性萎缩性胆囊炎的临床疗效比较[J].中国医药导报, 2009, 6(32):22-23.
26.	张志强, 张楠, 马杰, 等.萎缩性胆囊炎手术方式探讨[J].基层医学论坛, 2012, 16(7):950-951.

1. 周钱江, 王跃东, 竺杨文, 等.慢性萎缩性胆囊炎腹腔镜切除术95例临床分析[J].肝胆胰外科杂志, 2008, 20(4):288-289.
2. 陈广泰.腹腔镜胆囊切除术治疗慢性萎缩性胆囊炎临床分析[J].中外医疗, 2010, 29(32):92.
3. 廉世松, 杨吉田, 彭玲霞.沅陵县农村居民胆囊结石的调查分析[J].中国民康医学, 2011, 23(3):336-337.
4. 谭宜将, 刘衍民.胆囊结石发病原因研究现状与进展[J].中国实用外科杂志, 2009, 29(7):602-603, 606.
5. 史建中, 万焕真.腹腔镜胆囊切除术在老年急性胆囊炎患者中的应用探讨[J].中国普通外科杂志, 2011, 20(8):895-897.
6. 胡三元.腹腔镜临床诊治技术[M].济南:山东科学技术出版社, 2002:77.
7. Giger U, Michel JM, Vonlanthen R, et al. Laparoscopic cholecystectomy in acute cholecystitis:indication, technique, risk and outcome[J]. Langenbecks Arch Surg, 2005, 390(5):373-380.
8. 王和曹, 余鹏.腹腔镜胆囊切除术治疗急性胆囊炎46例分析[J].肝胆胰外科杂志, 2009, 21(1):74-75.
9. Higgins JPT GSe. Cochrane Handbook for Systematic Reviews of Interventions Version 5. 1. 0[DB/OL]. Available from http://www.cochrane.org/handbook.
10. Jadad AR, Moore RA, Carroll D, et al. Assessing the quality of reports of randomized clinical trials:is blinding necessary?[J]. Control Clin Trials, 1996, 17(1):1-12.
11. 余辉.腹腔镜胆囊切除术对慢性萎缩性胆囊炎的疗效分析[J].中国民族民间医药, 2012, 21(24):79.
12. 贾丹.腹腔镜手术治疗慢性萎缩性胆囊炎80例的效果分析[J].中国医学创新, 2013, 10(24):117-118.
13. 张县强.腹腔镜手术治疗慢性萎缩性胆囊炎的临床效果分析[J].中国医药科学, 2012, 2(8):166-167.
14. 吴伟, 余育晖.腹腔镜与传统开腹手术治疗慢性萎缩性胆囊炎的临床疗效对照研究[J].中国普通外科杂志, 2013, 22(8): 1090-1092.
15. 薛应祥, 黄健.腹腔镜与开腹胆囊摘除术的效果比较[J].西部医学, 2011, 23(3):509-510.
16. 张坤, 所广军, 陈铜兵.腹腔镜与开腹手术治疗慢性萎缩性胆囊炎的疗效比较[J].北方药学, 2012, 9(12):51.
17. 王昌松, 罗洪, 赵少勇.腹腔镜与开腹手术治疗慢性萎缩性胆囊炎的临床疗效比较[J].航空航天医药, 2010, 21(7):1143-1144.
18. 何振兴, 马海, 杨红春, 等.年轻医师腹腔镜胆囊切除术的学习曲线探讨[J].中国普外基础与临床杂志, 2013, 20(11): 1284-1286.
19. 夏永红.腹腔镜胆囊切除术和开腹胆囊切除术后并发症发生率的比较[J].中国普通外科杂志, 2012, 21(8):1010-1012.
20. 葛长青, 李全福, 刘建辉, 等.腹腔镜辅助胆道镜保胆取石术与腹腔镜胆囊切除术的比较[J].中国内镜杂志, 2012, 18(2): 199-202.
21. 卢茂松, 刘强, 黄征焘.电视腹腔镜胆囊切除术及小切口开腹胆囊切除术的临床比较[J].现代预防医学, 2011, 38(2): 380-381.
22. 梁治升, 崔清枫, 勾承月.慢性萎缩性胆囊炎的腹腔镜治疗[J].中国医药导报, 2009, 6(16):55-56.
23. 吴碧胜, 向建军.腹腔镜和传统开腹胆囊切除术对患者肠道黏膜通透性影响的比较[J].中国普通外科杂志, 2013, 22(4): 532-535.
24. 汪卫平.腹腔镜与开腹手术治疗慢性萎缩性胆囊炎的临床疗效比较[J].中外医学研究, 2011, 9(26):34-35.
25. 梁治升, 崔清枫, 勾承月.腹腔镜与开腹手术治疗慢性萎缩性胆囊炎的临床疗效比较[J].中国医药导报, 2009, 6(32):22-23.
26. 张志强, 张楠, 马杰, 等.萎缩性胆囊炎手术方式探讨[J].基层医学论坛, 2012, 16(7):950-951.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Effects and Safety of Laparoscopic Cholecystectomy and Open Cholecystectomy for Chronic Atrophic Cholecystitis:A Meta-Analysis of RCTs

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