Severe Gallstone Pancreatitis Surgical Timing Of Meta-analysis

Objective：To analyze and compare the effect of early surgical treatment and delaysurgery treatment for patients with severe gallstone pancreatitis .Methods：According to the including criteria，twenty controlled clinical trial of thistopic were enrolled into the analysis. The detail about the trial design, characters ofthe subjects and results of the studies were reviewed and analyzed by using RevMan5.1 software.Results：Compared with delay surgical treatment，early surgical treatment was higherincidence of complications(OR=2.37,95%CI:0.99～5.65, P=0.05) and again theoperation rate (OR=5.17,95%CI:1.85～14.45, P=0.002). But mortality(OR=1.88,95%CI: 0.94～3.77, P=0.08) and hospital stay duration(MD=6.49,95%CI:－13.32～26.30, (P=0.52) have no statistically significant. The subgroup analysisindicated that non obstruction type severe gallstone pancreatitis with early surgicaltreatment and delay surgical treatment have no statistically significant in mortality（OR=1.06,95%CI:0.35～3.21, P=0.92）,but the former was higher than the latter incomplications scoring(MD=2.00,95%CI:1.00～3.00,P<0.0001);Obstruction typesevere gallstone pancreatitis with early surgical treatment and delay surgical treatmenthave no statistically significant in mortality（OR=0.60,95%CI:0.21～1.70,P=0.34）,but the former was higher than the latter in complications scoring(MD=1.37,95%CI:0.51～2.23, P=0.002).Conclusions：The choice of the operation time has the effect of severe gallstonepancreatitis treatment. the combination of delayed and selective surgery is suggested,but for the patient with operation indications，we should consider to surgical treatmenttimely.