怀孕期间胆囊疾病的最佳治疗策略:通过双网络元分析进行系统审查
Ye Xin Koh1,2,3, Yun Zhao4, Ivan En-Howe Tan4
1Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital and National Cancer Centre Singapore, Academia, 20 College Road, Singapore, 169856, Singapore. koh.ye.xin@outlook.com.
Surgical endoscopy
|October 15, 2024
概括
腹腔镜胆囊切除术 (LC) 是怀孕期间胆囊疾病的最佳治疗方法,比保守的治疗或开放性手术显示出早产和并发症的风险较低. 胆囊切除术在三个月内是安全的,但第三个月的手术需要谨慎.
科学领域:
- 产科和妇科 产科和妇科
- 外科胃肠道外科手术
- 孕产妇和胎儿医学 孕产妇和胎儿医学
背景情况:
- 胆囊疾病在怀孕期间带来管理挑战.
- 怀孕患者胆囊切除术的最佳手术策略和时间仍在争论中.
- 评估保守管理 (CM),腹腔镜胆囊切除术 (LC) 和开放胆囊切除术 (OC) 是至关重要的.
研究的目的:
- 确定怀孕期间胆囊疾病的最佳治疗策略.
- 在孕妇患者中比较CM,LC和OC的有效性和结果.
- 分析胆囊切除术在不同孕期的结果.
主要方法:
- 进行了全面的文献搜索,直到2024年2月.
- 在每组至少有10个病例的研究中,进行了两次贝叶斯网络元分析 (NMA).
- 计算了风险比率 (RR),平均差异 (MD) 和95%可信区间 (CrIs).
主要成果:
- 与CM和OC相比,LC显著降低了早产,胎儿并发症和母亲并发症的风险.
- LC与比OC更短的住院时间有关.
- 在三个月之间没有发现早产或堕胎率的显著差异,但第三个月的手术增加了母亲的并发症风险.
结论:
- 腹腔镜胆囊切除术 (LC) 是在怀孕期间治疗胆囊疾病的首选手术方法.
- 胆囊切除术可以在任何三个月内安全地进行,由于母亲的并发症风险增加,建议仔细考虑第三个月的手术.
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