Comparison of safety and efficacy of one-stage and two-stage percutaneous transhepatic cholangioscopic lithotomy for patients with hepatolithiasis in China: a Meta-analysis
Objective:To systematically evaluate and compare the efficacy and safety of one-stage and two-stage percutaneous transhepatic cholangioscopic lithotomy (PTCSL) in the treatment of patients with hepatolithiasis in China.Methods:Controlled trials related to one-stage or two-stage PTCSL in the treatment of hepatolithiasis in China published between January 2012 and January 2022 were searched in CNKI, Wanfang Data, Chongqing VIP, Embase, PubMed and Cochrane Library in both Chinese and English. The searching terms mainly consisted of hepatolithiasis, one stage, second stage and percutaneous hepatocholangioscopy. Literature searching, literature screening and information extraction were performed by two independent researchers. RevMan 5.4 software was used for Meta-analysis.Results:8 eligible articles were included, including 3 randomized controlled trials and 5 cohort studies, with a total sample size of 748 cases, 350 cases in one stage group and 398 cases in two stage group. Meta-analysis showed that no significant difference was observed in the operation time and intraoperative blood loss (MD=0.20, 0.97; P>0.05), the stone clearance rate and the incidence of total postoperative complications (RR=1.04, 1.31; P>0.05) between the one-stage and two-stage PTCSL for hepatolithiasis. The length of hospital stay of patients in the one-stage group was significantly shorter than that in the two-stage group (MD=-2.36, P<0.05), whereas the incidence of postoperative biliary bleeding in the one-stage group was significantly higher than that in the two-stage group (RR=1.79, P<0.05).Conclusions:Compared with one-stage PTCSL, two-stage PTCSL requires longer length of hospital stay, whereas yields lower incidence of postoperative biliary bleeding in treating patients with hepatolithiasis in China.
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