Meta-analysis Of Safety And Effectiveness Of Precision Hepatectomy And Non-precision Hepatectomy For Intrahepatic Bile Duct Stones In The Past 5 Years

Objective: To compare the intraoperative and postoperative indicators of precise hepatectomy and imprecise hepatectomy for intrahepatic bile duct stones in the past 5 years by meta analysis,and to explore the safety of precise hepatectomy in patients with intrahepatic bile duct stones.Sex and effectiveness.Methods: Manual search and computer search were used to search the foreign databases PubMed,Cochrane library,and embase.The Chinese databases HowNet,Weipu,and Wanfang were searched.The search time was from January 2015 to January 2020.The search content was precision liver Documents compared with resection and non-accurate liver resection.The retrieved documents were imported into EndNote software for document selection.Finally,the selected documents were subjected to meta-analysis using Review Manager5.3.Results: A total of 955 patients with intrahepatic bile duct stones were included in the meta-analysis,of which 478 patients underwent precision liver resection and 477 patients underwent inaccurate liver resection.In the basic situation of the precise group and the non-precision group,the age(MD =-0.31,95% CI:-0.67~ 0.04,P=0.09),gender(OR =0.99,95% CI: 0.76~1.28,P=0.92;for womenOR = 0.79,95% CI: 0.79~1.33,P=0.87),stone distribution(unilateral OR = 1.01,95% CI:0.59~1.71,P=0.99;bilateral OR = 0.99,95% CI: 0.59~1.68,P=0.99)were not statistically significant.In the observation group,the precision group and the non-precision group showed the intraoperative blood loss(MD =-208.17,95% CI:-236.93~-179.41,P < 0.00001),and the hospital stay(MD =-4.78,95% CI:-5.03~-4.53,P < 0.00001).In terms of postoperative complications(OR = 0.28,95% CI: 0.19~0.42,P<0.00001)and postoperative stone residuals(OR = 0.20,95% CI: 0.1~0.38,P <0.00001),the precision group has a significant advantage over the non-precision group;in surgery In terms of time(MD = 24.83,95% CI:-4.00~53.66,P=0.09),there was no significant statistical difference between the precise group and the inaccurate group.Conclusion: In the past 5 years,precisise hepatectomy has the advantages of reducing intraoperative blood loss,shortening the length of hospital stay,reducing postoperative complications,and reducing postoperative stone residuals.There is no significant difference in the operation time.The safety and effectiveness of precise hepatectomy in the treatment of intrahepatic bile duct stones are worth affirming.