Risk Factors Of Bile Duct Injury Caused By Laparoscopic Cholecystectomy:A Meta-analysis

Objective:To explore the risk factors of bile duct injury caused by laparoscopic cholecystectomy by Meta-analysis,and provide a theoretical basis to reduce the incidence of bile duct injury syndrome.Methods:A systematic search of PUBMED,EMbase,Cochrane Library,CNKI,VIP and WanFang databases performed to identify articles about risk factors of bile duct injury after laparoscopic cholecystectomy,After quality assessment and data extraction of all articles,a meta-analysis was performed with R3.6.2 software for statistic analysis.Results:A total of 15 meta-analyzes were included in this study,the met hod were case-control studies,The total sample size was 34645 cases,389 cases appear bile duct injury.The results of meta-analysis showed that gender(OR:1.6228,95%CI:[1.1287;2.3331],P=0.0090),the gallbladder acute inflammation(OR:5.1717,95%CI:[3.9397;6.7890],P<0.0001),thickness of gallbladder wall(OR:2.3220,95%CI:[1.1483;4.6953],P=0.0190),anatomy variations of Cal ot's triangle(OR:14.1520,95%CI:[5.8769;34.0788],P?0.0001),length of cysti c duct(OR:4.2995,95%CI:[2.8671;6.4475],P?0.0001),adhesion in operative(OR:3.4850,95%CI:[1.9973;6.0811],P?0.0001),intraoperative bleeding(OR:4.7026,95%CI:[1.5453;14.3105],P=0.0064),operator's experience(OR:7.4676,95%CI:[3.7580;14.8389],P?0.0001)were risk factors of BDI.But the age?ob esity?preoperative liver function?the operation time(P?0.5)are not the risk fac tor of BDI.Conclusion:(1)the thickness of the gallbladder wall in the acute or suba cute phase of gallbladder inflammation in men with an anatomical variation in the gallbladder triangle(?3mm)and the length of the gallbladder duct?10mm during the intraoperative adhesion considered as a risk factor of BDI.(2)age,obesity,preoperative liver function,the operative time was not co nsidered as a risk factor of BDI.