| Objective: Under the condition of relatively large sample, system evaluation the difference of Laparoscopic liver resection and open liver resection for left intrahepatic bile duct stones in the operation time,bleeding volume, postoperative anal exhaust time, the postoperative hospital stay and postoperative complications, analysis the safety and feasibility of laparoscopic liver resection.Methods: search in the PubMed,CNKI, CBM, WanFang, Data Base and other knowledge platform to collect laparoscopic liver resection and open hepatectomy for hepatolithiasis randomized or non randomized controlled trials, selected high quality literature according to NOS,and then do the Meta analysis study 。Results:the final selection of 6 papers, including 5 Chinese papers, 1 English papers, a total of 714 patients were included. 6 articles were recorded in the operation time, the total number of cases 714, by review Manager5.2analysis of comparative literature homogeneity. Results P < 0.00001, I2=98%,the poor homogeneity, should use the random effect model of Meta analysis.The results showed that [MD=33.23,95%CI(3.94,62.53, P=0.03]), no significant difference between the LH and OH group in the operation time.Included 6 articles were recorded in the amount of bleeding,the total number were 714 cases, by review manager5.2 Meta analysis software to analyze the literature homogeneity, the results suggest that P < 0.00001, I2=98%,indicating that literature poor homogeneity. So we use random effects model analysis. Meta analysis showed that MD=111.36,95%CI(45.48177.25),P=0.0009,that difference in bleeding in laparoscopic group and open group was nostatistical significance. The 6 articles were included 2 papers did not record the postoperative exhaust time, the total number of cases were 470 cases, by review manager5.2 analysis with the literature The qualitative results, return P<0.00001, I2=95%, indicating that literature poor homogeneity, we should use the random effects model by Meta analysis. The results showed that MD=1.03,95%CI(0.46,1.62), P=0.00005.The coclution is that in postoperative exhaust time,laparoscopic group is shorter than the open group. The included 6 articles 1 articles did not record the Postoperative hospital stay, the total number of cases included in 590 cases,by review manager5.2 Meta analysis software to analyze the results of literature homogeneity return P=0.1, I2=48% shows good homogeneity, we can use the fixed effect model of the Meta analysis. The results showed that MD=4.40,95%CI(3.83,4.96), P< 0.00001 that there was a significant difference between the two groups, further illustrate the laparoscopic group postoperative hospital stay shorter than open group. Included 6articles all recorded postoperative complications included 714 cases, by review manager5.2 analysis software analyzer literature return P=0.63,I2=0% shows good homogeneity,we can use the fixed effect model of Meta analysis. The results showed that MD=1.74,95%CI(1.12,2.71), P=0.01],illustrate the differences of complications of the two group had no statistical significance.Conclusion: In this Meta analysis,we can see aparoscopic resection and resection in the treatment of left intrahepatic bile duct stones in the operation time, intraoperative bleeding and postoperative complications has no significant difference,but the postoperative anal exhaust time and postoperative hospitalization time, laparoscopic hepatic lobectomy patients were shorter than the open liver resection group. So under in strictly grasp the indications and contraindications of laparoscopic surgery cases of laparoscopic hepatic lobe resection in the treatment of left intrahepatic bile duct stones is safe and feasible, and the recovery time is superior to laparotomy in postoperative liver Lobectomy. |
PDF Full Text Request