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Endoscopy Lithotomy for Intrahepatic Gallstones: A Meta-Analysis
Shumin Ma1, Sanyuan Hu, Feng Gao
1*Department of General Surgery, Qilu Hospital of Shandong University, Jinan †Department of General Surgery, Qingdao Hiser Hospital ‡Department of Obstetrics, Qingdao Women and Children's Hospital, Qingdao, Shandong, People's Republic of China.
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
|March 24, 2015
Summary
Intrahepatic biliary strictures negatively impact endoscopic treatment success for intrahepatic gallstones, leading to lower clearance and higher recurrence rates. Complete stone removal is crucial for preventing complications.
Area of Science:
- Gastroenterology
- Hepatology
- Endoscopic Surgery
Background:
- Endoscopic lithotomy is a standard treatment for intrahepatic gallstones.
- The impact of biliary strictures on treatment outcomes remains debated.
Purpose of the Study:
- To investigate the influence of intrahepatic biliary strictures on the efficacy of endoscopic lithotomy for intrahepatic gallstones.
- To analyze clearance rates, recurrence, and complications associated with strictures.
Main Methods:
- Systematic literature search of multiple databases (PubMed, EMBASE, Cochrane, etc.).
- Meta-analysis of thirteen included studies using RevMan 5.2.
- Analysis of complete clearance, recurrence, and major complication rates.
Main Results:
- Intrahepatic duct strictures were associated with significantly lower complete clearance rates.
- Patients with strictures experienced significantly higher rates of gallstone recurrence.
- Complete stone removal correlated with a lower morbidity rate from major complications.
Conclusions:
- Intrahepatic biliary strictures are a significant factor in treatment failure and recurrence of intrahepatic stones.
- Complete eradication of intrahepatic gallstones is essential for preventing recurrent cholangitis and cholangiocarcinoma.
- Addressing strictures may improve endoscopic lithotomy outcomes.