Primary closure versus T-tube drainage in laparoscopic common bile duct exploration：a Meta analysis

Abstract:

Objective：To systematically evaluate the efficacy of primary closure（PC） versus T-tube drainage（TD） in laparoscopic common bile duct exploration（LCBDE） in the treatment of choledocholithiasis. Methods：Clinical trials，which compared the effi－cacy of PC versus TD LCBDE in the treatment of choledocholithiasis were electronically searched from the Cochrane Library，PubMed，EMbase，CBM，CNKI data bases from 2000 to 2012 and the RevMan 5.0 software was used for data analysis. Results：Five trials with 572 patients were included. Meta-analysis revealed that there was no significant difference in incidences of biliary related complications between PC and TD groups（RR=0.87，95%CI[0.46，1.63]，P=0.66）. Operating time（WMD=-28.66，95%CI[-34.00，-23.32]，P<0.000 01），postoperative hospitalization duration（WMD=-3.03，95%CI[-3.85，-2.47]，P<0.000 01） and total complication incidences（RR=0.55，95%CI[0.34，0.89]，P=0.01） were decreased in PC group compared with those in TD group. Conclusions：PC in LCBDE is safe and effective；it is a preferred option in the treatment of choledocholithiasis.