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Research article
Cholecystectomy outcomes after endoscopic sphincterotomy in patients with choledocholithiasis: A meta-analysis
Chuang Yang
The third Hospital of Mianyang· Sichuan Mental Health Center
Corresponding Author
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View the published version at BMC Gastroenterology.
Background Endoscopic sphincterotomy is the standard treatment for common bile duct stones.There is different evidence considering complications specifically biliary pancreatitis and cholangitis with the use of cholecystectomy after endoscopic sphincterotomy.The purpose of this article is to compare the positive cholecystectomy after endoscopic treatment of common bile duct stones, whether the incidence of recurrent pancreatitis cholangitis is reduced, especially in high-risk patients.
Methods We searched Pubmed(1990-2019)、Embase(1990-2019)和 Cochrane(1990-2019)database for trials comparing the 2 strategies for gallstones after ES.A related article on the removal of gallbladder after endoscopic sphincterotomy was collected,followed by analysis of each group using RevMan.
Results We have adopted a total of 8 studies, including 7 randomized controlled trials and 1 retrospective study. A total of 12718 patients were included in the study, 4922 in the early cholecystectomy group, and 7795 in the gallbladder in situ group.During the follow-up period, 41 patients had pancreatitis after endoscopic sphincterotomy in the cholecystectomy group, and 177 patients in the wait-and-see group. The incidence of pancreatitis in the gallbladder in situ group was significantly reduced(RR 0.38, 95%CI 0.27 to 0.53, P < 0.00001,I 2 =0%).The incidence of cholangitis and jaundice in the removal of the gallbladder group was also less than that in the preserved gallbladder group(RR 0.31, 95%CI 0.26 to 0.38, P < 0.00001,I 2 =0%).There was no significant difference in mortality between the two groups(RR 0.73, 95%CI 0.52 to 1.02, P =0.07,I 2 =14%).There is a significant difference in cholecystitis or biliary colic(RR 0.25, 95% CI 0.21 to 0.29, P < 0.00001,I 2 =28%).
Conclusions Early endoscopic cholecystectomy after removal of common bile duct stones can effectively reduce biliary complications such as recurrent pancreatitis, cholangitis and cholecystitis. This is still true for high-risk patients, and has no significant effect on the mortality of patients. After ES,laparoscopic cholecystectomy should be recommended.
Keywords
Cholecystectomy, Choledocholithiasis, Sphincterotomy, Meta-analysis
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Posted 04 Jun, 2020
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On 17 Jul, 2020
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Editor assigned
On 27 May, 2020
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On 26 May, 2020
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Editorial decision: Major revision
On 18 May, 2020
Review #3 received
Received 13 May, 2020
Reviewer #3 agreed
On 15 Apr, 2020
Review #1 received
Received 01 Mar, 2020
Review #2 received
Received 01 Mar, 2020
Reviewers invited
Invitations sent on 20 Feb, 2020
Reviewer #1 agreed
On 20 Feb, 2020
Reviewer #2 agreed
On 20 Feb, 2020
Editor assigned
On 11 Feb, 2020
Submission checks complete
On 10 Feb, 2020
Editor invited
On 10 Feb, 2020
No comments provided
Editorial decision: Major revision
On 27 Jan, 2020
Review #3 received
Received 23 Jan, 2020
Reviewer #3 agreed
On 22 Jan, 2020
Review #1 received
Received 28 Dec, 2019
Review #2 received
Received 28 Dec, 2019
Reviewer #1 agreed
On 22 Dec, 2019
Reviewer #2 agreed
On 22 Dec, 2019
Reviewers invited
Invitations sent on 19 Dec, 2019
Editor assigned
On 16 Dec, 2019
Submission checks complete
On 29 Nov, 2019
Editor invited
On 27 Nov, 2019
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Subject Areas
Hepatobiliary & Transplant Surgery
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This preprint is under consideration at BMC Gastroenterology. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Cholecystectomy outcomes after endoscopic sphincterotomy in patients with choledocholithiasis: A meta-analysis
Chuang Yang
The third Hospital of Mianyang· Sichuan Mental Health Center
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 3
Posted 04 Jun, 2020
Published
On 17 Jul, 2020
No community comments so far
Editor assigned
On 27 May, 2020
Submission checks complete
On 26 May, 2020
Editor invited
On 26 May, 2020
No comments provided
Editorial decision: Major revision
On 18 May, 2020
Review #3 received
Received 13 May, 2020
Reviewer #3 agreed
On 15 Apr, 2020
Review #1 received
Received 01 Mar, 2020
Review #2 received
Received 01 Mar, 2020
Reviewers invited
Invitations sent on 20 Feb, 2020
Reviewer #1 agreed
On 20 Feb, 2020
Reviewer #2 agreed
On 20 Feb, 2020
Editor assigned
On 11 Feb, 2020
Submission checks complete
On 10 Feb, 2020
Editor invited
On 10 Feb, 2020
No comments provided
Editorial decision: Major revision
On 27 Jan, 2020
Review #3 received
Received 23 Jan, 2020
Reviewer #3 agreed
On 22 Jan, 2020
Review #1 received
Received 28 Dec, 2019
Review #2 received
Received 28 Dec, 2019
Reviewer #1 agreed
On 22 Dec, 2019
Reviewer #2 agreed
On 22 Dec, 2019
Reviewers invited
Invitations sent on 19 Dec, 2019
Editor assigned
On 16 Dec, 2019
Submission checks complete
On 29 Nov, 2019
Editor invited
On 27 Nov, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Hepatobiliary & Transplant Surgery
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Gastroenterology.
Background Endoscopic sphincterotomy is the standard treatment for common bile duct stones.There is different evidence considering complications specifically biliary pancreatitis and cholangitis with the use of cholecystectomy after endoscopic sphincterotomy.The purpose of this article is to compare the positive cholecystectomy after endoscopic treatment of common bile duct stones, whether the incidence of recurrent pancreatitis cholangitis is reduced, especially in high-risk patients.
Methods We searched Pubmed(1990-2019)、Embase(1990-2019)和 Cochrane(1990-2019)database for trials comparing the 2 strategies for gallstones after ES.A related article on the removal of gallbladder after endoscopic sphincterotomy was collected,followed by analysis of each group using RevMan.
Results We have adopted a total of 8 studies, including 7 randomized controlled trials and 1 retrospective study. A total of 12718 patients were included in the study, 4922 in the early cholecystectomy group, and 7795 in the gallbladder in situ group.During the follow-up period, 41 patients had pancreatitis after endoscopic sphincterotomy in the cholecystectomy group, and 177 patients in the wait-and-see group. The incidence of pancreatitis in the gallbladder in situ group was significantly reduced(RR 0.38, 95%CI 0.27 to 0.53, P < 0.00001,I 2 =0%).The incidence of cholangitis and jaundice in the removal of the gallbladder group was also less than that in the preserved gallbladder group(RR 0.31, 95%CI 0.26 to 0.38, P < 0.00001,I 2 =0%).There was no significant difference in mortality between the two groups(RR 0.73, 95%CI 0.52 to 1.02, P =0.07,I 2 =14%).There is a significant difference in cholecystitis or biliary colic(RR 0.25, 95% CI 0.21 to 0.29, P < 0.00001,I 2 =28%).
Conclusions Early endoscopic cholecystectomy after removal of common bile duct stones can effectively reduce biliary complications such as recurrent pancreatitis, cholangitis and cholecystitis. This is still true for high-risk patients, and has no significant effect on the mortality of patients. After ES,laparoscopic cholecystectomy should be recommended.
Figure 1
Figure 2
Figure 3
Figure 4
Figure 5
Figure 6
Due to technical limitations, the table could not be displayed here. Please see the supplementary files section to access the table.