Analysis of risk factors for bile duct injury in laparoscopic cholecystectomy in China: A systematic review and meta-analysis

Abstract

Background: To explore the risk factors of bile duct injury in laparoscopic cholecystectomy (LC) in China through meta-analysis. Methods: The study commenced with a search and selection of case-control studies on the risk factors for bile duct injury in LC in China using the following databases: PubMed, EMBASE, ScienceNet.cn, CNKI, Wanfang Data, and VIP. Data were extracted from the collected documents independently by 2 researchers, following which a meta-analysis of these data was performed using Revman 5.3. Results: The compilation of all data from a total of 19 case-control studies revealed that among 41,044 patients, 458 patients experienced bile duct injury in LC, accounting for the incidence rate of 1.12% for bile duct injury. The revealed risk factors for bile duct injury were age (≥40 years) (odds ratio [OR] = 6.23, 95% CI [95% confidence interval]: 3.42-11.33, P < .001), abnormal preoperative liver function (OR = 2.01, 95% CI: 1.50-2.70, P < .001), acute and subacute inflammation of gallbladder (OR = 8.35, 95% CI: 5.32-13.10, P < .001; OR = 4.26, 95% CI: 2.73-6.65, P < .001), thickening of gallbladder wall (≥4 mm) (OR = 3.18, 95% CI: 2.34-4.34, P < .001), cholecystolithiasis complicated with effusion (OR = 3.05, 95% CI: 1.39-6.71, P = .006), and the anatomic variations of the gallbladder triangle (OR = 11.82, 95% CI: 6.32-22.09, P