[1]王 志,蒋宏伟,冯汝状.腹腔镜胆囊切除术发生胆管损伤危险因素的Meta分析[J].医学信息,2023,36(20):69-73,82.[doi:10.3969/j.issn.1006-1959.2023.20.013]
 WANG Zhi,JIANG Hong-wei,FENG Ru-zhuang.Meta-analysis of Risk Factors for Bile Duct Injury in Laparoscopic Cholecystectomy[J].Journal of Medical Information,2023,36(20):69-73,82.[doi:10.3969/j.issn.1006-1959.2023.20.013]
点击复制

腹腔镜胆囊切除术发生胆管损伤危险因素的Meta分析()
分享到:

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
36卷
期数:
2023年20期
页码:
69-73,82
栏目:
医学数据科学
出版日期:
2023-10-15

文章信息/Info

Title:
Meta-analysis of Risk Factors for Bile Duct Injury in Laparoscopic Cholecystectomy
文章编号:
1006-1959(2023)20-0069-06
作者:
王 志蒋宏伟冯汝状
(楚雄州人民医院新区医院肝胆外二科,云南 楚雄 650500)
Author(s):
WANG ZhiJIANG Hong-weiFENG Ru-zhuang
(The Second Department of Hepatobiliary Surgery,New District Hospital of Chuxiong People’s Hospital,Chuxiong 650500,Yunnan,China)
关键词:
腹腔镜胆囊切除术胆管损伤危险因素胆汁性腹膜炎
Keywords:
Laparoscopic cholecystectomyBile duct injuryRisk factorsCholeperitonitis
分类号:
R657.4
DOI:
10.3969/j.issn.1006-1959.2023.20.013
文献标志码:
A
摘要:
目的 探讨腹腔镜胆囊切除术发生胆管损伤的危险因素。方法 计算机检索中国知网(CNKI)、万方数据知识服务平台、中国生物医学文献服务平台、维普资讯中文期刊服务平台、PubMed、Web of Science、Cochrane Library以及EMbase数据库在建库至2022年11月10日公开发表的腹腔镜胆囊切除术发生胆管损伤相关文献。由两位评价人员分别独立筛选文献、提取数据,并进行文献质量评价。采用RevMan 5.3软件进行Meta分析。结果 最终入选6篇文献,均为回顾性病例对照研究,共19 411例患者,腹腔镜胆囊切除术发生胆管损伤共151例患者,未发生胆管损伤共19 260例患者,胆管损伤发生率为0.78%。Meta分析显示,胆囊(胆管)解剖异常[OR=69.24,95%CI(43.34,110.62),P<0.000 01]、术者经验差[OR=9.16,95%CI(5.12,16.37),P<0.000 01]为腹腔镜胆囊切除术发生胆管损伤的危险因素。结论 胆管解剖异常、术者经验差为腹腔镜胆囊切除术发生胆管损伤危险因素。临床医生应注意相关危险因素,尽可能避免胆管损伤,提高患者术后生活质量。
Abstract:
Objective To investigate the risk factors of bile duct injury in laparoscopic cholecystectomy.Methods China National Knowledge Infrastructure (CNKI), Wanfang Data Knowledge Service Platform, Chinese Biomedical Literature Service Platform, VIP Information Chinese Journal Service Platform, PubMed, Web of Science, Cochrane Library and EMbase Database were searched by computer to retrieve the literature related to bile duct injury in laparoscopic cholecystectomy published between the establishment of the database and November 10, 2022. Two evaluators independently screened the literature, extracted the data, and evaluated the quality of the literature. Meta-analysis was performed using RevMan 5.3 software.Results Finally, 6 literatures were included, all of which were retrospective case-control studies, with a total of 19 411 patients, 151 patients with laparoscopic cholecystectomy with bile duct injury, and 19 260 patients without bile duct injury, with an incidence of 0.78%. Final Meta results showed that the anatomical abnormality of gallbladder (bile duct) [OR=69.24,95%CI(43.34,110.62),P<0.000 01], the operator had poor experience [OR=9.16,95%CI(5.12,16.37),P<0.000 01] were the risk factor for bile duct injury in laparoscopic cholecystectomy.Conclusion Abnormal bile duct anatomy and poor experience are risk factors for bile duct injury in laparoscopic cholecystectomy. Clinicians should pay attention to relevant risk factors, avoid bile duct injury as much as possible, and improve the quality of life of patients after surgery.

参考文献/References:

[1]Cianci P,Restini E.Management of cholelithiasis with choledocholithiasis: Endoscopic and surgical approaches[J].World J Gastroenterol,2021,27(28):4536-4554.[2]Strasberg SM.A three-step conceptual roadmap for avoiding bile duct injury in laparoscopic cholecystectomy:an invited perspective review[J].J Hepatobiliary Pancreat Sci,2019,26(4):123-127.[3]Abbasoglu O,Tekant Y,Alper A,et al.Prevention and acute management of biliary injuries during laparoscopic cholecystectomy: Expert consensus statement[J].Ulus Cerrahi Derg,2016,32(4):300-305.[4]Madanur MA,Battula N,Sethi H,et al.Pseudoaneurysm following laparoscopic cholecystectomy[J].Hepatobiliary Pancreat Dis Int,2007,6(3):294-298.[5]Donkervoort SC,Dijksman LM,van Dijk AH,et al.Bile leakage after loop closure vs clip closure of the cystic duct during laparoscopic cholecystectomy: A retrospective analysis of a prospective cohort[J].World J Gastrointest Surg,2020,12(1):9-16.[6]Ely S,Rothenberg KA,Beattie G,et al.Modern Elective Laparoscopic Cholecystectomy Carries Extremely Low Postoperative Infection Risk[J].J Surg Res,2020,246:506-511.[7]El-Dhuwaib Y,Slavin J,Corless DJ,et al.Bile duct reconstruction following laparoscopic cholecystectomy in England[J].Surg Endosc,2016,30(8):3516-3525.[8]Stang A.Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses[J].Eur J Epidemiol,2010,25(9):603-605.[9]胡星星.腹腔镜下胆囊切除术中胆道损伤情况及其影响因素[J].江西医药,2022,57(2):199-201.[10]周党军,白凤娇,韩博强,等.腹腔镜胆囊切除术致胆管损伤相关危险因素[J].中华肝胆外科杂志,2016,22(9):614-617.[11]汪俊科,廖振宇,肖连斌.LC术中胆道损伤的危险因素及预防分析[J].中国现代普通外科进展,2013,16(7):558-561.[12]袁德汉,陈应军,卫洪波,等.腹腔镜胆囊切除术所致胆道损伤的相关危险因素分析[J].中国内镜杂志,2013,19(5):492-495.[13]宋峰峰.腹腔镜胆囊切除术致胆道损伤的危险因素分析[D].太原:山西医科大学,2013.[14]王宏,罗建管,梁鹏,等.腹腔镜胆囊切除术胆管损伤危险因素分析[J].中国实用外科杂志,2011,31(7):591-593.[15]Kamisawa T,Kaneko K,Itoi T,et al.Pancreaticobiliary maljunction and congenital biliary dilatation[J].Lancet Gastroenterol Hepatol,2017,2(8):610-618.[16]Ko K,Kamiya J,Nagino M,et al.A study of the subvesical bile duct (duct of Luschka) in resected liver specimens[J].World J Surg,2006,30(7):1316-1320.[17]张建立,康敬辉,邱红芳,等.腹腔镜胆囊切除术肝外胆管损伤的预防策略分析[J].基层医学论坛,2014,18(2):174-175.[18]Noji T,Nakamura F,Nakamura T,et al.ENBD tube placement prior to laparoscopic cholecystectomy may reduce the rate of complications in cases with predictably complicating biliary anomalies[J].J Gastroenterol,2011,46(1):73-77.[19]Yang C,Wu HS,Chen XL,et al.Pylorus-preserving versus pylorus-resecting pancreaticoduodenectomy for periampullary and pancreatic carcinoma: a meta-analysis[J].PLoS One,2014,9(3):e90316.[20]Yamada K,Yamashita Y,Yamada T,et al.Optimal timing for performing percutaneous transhepatic gallbladder drainage and subsequent cholecystectomy for better management of acute cholecystitis[J].J Hepatobiliary Pancreat Sci,2015,22(12):855-861.[21]全志伟,王健东.胆道外科若干焦点问题和研究方向[J].中国实用外科杂志,2018,38(1):45-47.[22]McKinley SK,Brunt LM,Schwaitzberg SD.Prevention of bile duct injury:the case for incorporating educational theories of expertise[J].Surg Endosc,2014,28(12):3385-3391.[23]Vazquez RM.Common sense and common bile duct injury: common bile duct injury revisited[J].Surg Endosc,2008,22(8):1743-1745.[24]MacFadyen BV Jr,Vecchio R,Ricardo AE,et al.Bile duct injury after laparoscopic cholecystectomy.The United States experience[J].Surg Endosc,1998,12(4):315-321.[25]Van de Graaf FW,Za?觙mi I,Stassen LPS,et al.Safe laparoscopic cholecystectomy: A systematic review of bile duct injury prevention[J].Int J Surg,2018,60:164-172.

相似文献/References:

[1]尹增盛,李淑琴,崔 辉.不同压力二氧化碳气腹对老年腹腔镜胆囊切除术患者术后认知功能的影响[J].医学信息,2018,31(20):86.[doi:10.3969/j.issn.1006-1959.2018.20.024]
 YIN Zeng-sheng,LI Shu-qin,CUI Hui.Effect of Different Pressure Carbon Dioxide Pneumoperitoneum on Postoperative Cognitive Function in Elderly Patients Undergoing Laparoscopic Cholecystectomy[J].Journal of Medical Information,2018,31(20):86.[doi:10.3969/j.issn.1006-1959.2018.20.024]
[2]孙 伟.腹腔镜胆囊切除术治疗结石性胆囊炎的临床效果观察[J].医学信息,2019,32(03):113.[doi:10.3969/j.issn.1006-1959.2019.03.035]
 SUN Wei.Clinical Observation of Laparoscopic Cholecystectomy for Calculus Cholecystitis[J].Journal of Medical Information,2019,32(20):113.[doi:10.3969/j.issn.1006-1959.2019.03.035]
[3]俞卫铿.腹腔镜胆囊切除术治疗胆囊结石伴慢性胆囊炎患者临床疗效[J].医学信息,2022,35(17):110.[doi:10.3969/j.issn.1006-1959.2022.17.029]
 YU Wei-keng.Clinical Effect of Laparoscopic Cholecystectomy in Treatment of Patients with Gallstone and Chronic Cholecystitiss[J].Journal of Medical Information,2022,35(20):110.[doi:10.3969/j.issn.1006-1959.2022.17.029]
[4]巴 琳,曾凡荣,郭忠宝.地塞米松联合切口阻滞和腹腔内局部麻醉对腹腔镜胆囊切除术后的镇痛效果[J].医学信息,2020,33(08):167.[doi:10.3969/j.issn.1006-1959.2020.08.056]
 BA Lin,ZENG Fan-rong,GUO Zhong-bao.Analgesic Effect of Dexamethasone Combined with Incision Block and Intraperitoneal Local Anesthesia After Laparoscopic Cholecystectomy[J].Journal of Medical Information,2020,33(20):167.[doi:10.3969/j.issn.1006-1959.2020.08.056]
[5]王跃振,梁 皓,田本祎,等.超声引导下腹横肌平面阻滞在老年腹腔镜胆囊切除术中的应用[J].医学信息,2021,34(07):122.[doi:10.3969/j.issn.1006-1959.2021.07.033]
 WANG Yue-zhen,LIANG Hao,TIAN Ben-yi,et al.Application of Ultrasound-guided Transversus Abdominis Plane Block in Elderly Laparoscopic Cholecystectomy[J].Journal of Medical Information,2021,34(20):122.[doi:10.3969/j.issn.1006-1959.2021.07.033]
[6]郭丽娜.“5E”护理模式在腹腔镜胆囊切除术后患者中的应用效果[J].医学信息,2023,36(02):160.[doi:10.3969/j.issn.1006-1959.2023.02.035]
 GUO Li-na.Application Effect of "5E" Nursing Mode in Patients After Laparoscopic Cholecystectomy[J].Journal of Medical Information,2023,36(20):160.[doi:10.3969/j.issn.1006-1959.2023.02.035]
[7]黄雪薇,尹 泓,赵 聪,等.区域神经阻滞在腹腔镜胆囊切除术后镇痛的应用[J].医学信息,2021,34(16):33.[doi:10.3969/j.issn.1006-1959.2021.16.009]
 HUANG Xue-wei,YIN Hong,ZHAO Cong,et al.Application of Regional Nerve Block in Analgesia After Laparoscopic Cholecystectomy[J].Journal of Medical Information,2021,34(20):33.[doi:10.3969/j.issn.1006-1959.2021.16.009]
[8]葛子豪,姚 康,童朝刚.困难腹腔镜胆囊切除术术前评估及风险预测模型构建[J].医学信息,2023,36(07):41.[doi:10.3969/j.issn.1006-1959.2023.07.008]
 GE Zi-hao,YAO Kang,TONG Chao-gang.Preoperative Evaluation and Risk Prediction Model Construction of Difficult Laparoscopic Cholecystectomy[J].Journal of Medical Information,2023,36(20):41.[doi:10.3969/j.issn.1006-1959.2023.07.008]
[9]杨 琼.手术室综合护理对腹腔镜胆囊切除术患者应激反应及预后的影响[J].医学信息,2023,36(08):166.[doi:10.3969/j.issn.1006-1959.2023.08.037]
 YANG Qiong.Effect of Comprehensive Nursing in the Operating Room on Stress Response and Prognosis of Patients Undergoing Laparoscopic Cholecystectomy[J].Journal of Medical Information,2023,36(20):166.[doi:10.3969/j.issn.1006-1959.2023.08.037]
[10]刘君玲,苗长丰.柴胡舒肝散联合平胃散对腹腔镜胆囊切除术后胃肠功能的影响[J].医学信息,2021,34(21):162.[doi:10.3969/j.issn.1006-1959.2021.21.046]
 LIU Jun-ling,MIAO Chang-feng.Effect of Chaihu Shugan Powder Combined with Pingwei Powder on Gastrointestinal Function After Laparoscopic Cholecystectomy[J].Journal of Medical Information,2021,34(20):162.[doi:10.3969/j.issn.1006-1959.2021.21.046]

更新日期/Last Update: 1900-01-01