NETWORK META-ANALYSIS OF LCBDE AND ERCP RESPECTIVELY COMBINED WITH LAPAROSCOPIC CHOLECYSTECTOMY IN THE TREATMENT OF CHOLECYSTOLITHIASIS

Abstract

Objective: In order to reduce medical resource waste, it is necessary to compare the clinical effectiveness of laparoscopic cholecystectomy (LC) and endoscopic retrograde cholangiopancreatography (ERCP) when utilized in combination with laparoscopic common bile duct exploration (LCBDE) and cholecystectomy (LC), respectively. Methods: The published original documents of LCBDE and ERCP associated with LC in the therapies of cholecystolithiasis complicated with choledocholithiasis were searched by computer in CNKI, VIP, Wanfang, Web of Science, Embas, and other databases. The retrieval period was from the creation of the database to January 2023. The documents were screened and extracted in accordance with the inclusion and exclusion standards, and the quality of the included documents was assessed using the tool for assessing risk of bias suggested by the Cochrane Handbook (5.1.0). Lastly, a meta-analysis was performed using RevMan5.4 software. Results: There were nine total documents, all of which were case-control studies. In accordance with the forest chart's findings, there was no discernible variation in the pace at which stones were cleared between LCBDE and LC and ERCP and LC [OR = 0.97, 95% CI (0.94-1.01), P > 0.05]. For LCBDE and LC and ERCP and LC, there was no clear differentiation in the conversion to laparotomy rate [OR = 0.82, 95% CI (0.35-1.92), P > 0.05]. Between LCBDE associated with LC and ERCP combined with LC, there was no discernible variance in the rate of postoperative bile leakage [OR= 3.49, 95% CI (1.35-9.01), P > 0.05]. Comparing LCBDE associated with LC and ERCP combined with LC, there was no discernible variation in the rate of postoperative pancreatitis [OR = 1.46, 95% CI (0.88-2.42), P > 0.05]. Conclusion: The two procedures are equally safe and effective, and there are no appreciable differences in the rates of stone clearance, conversion to laparotomy, incidence of postoperative bile leakage, or risk of postoperative pancreatitis. However, more research is required to confirm and update the aforementioned conclusions.