目的比較腹腔鏡膽囊切除聯合膽總管探查術（LC＋LCBDE）與內鏡下Oddi括約肌切開取石聯合腹腔鏡膽囊切除術（EST＋LC）治療膽囊結石合并肝外膽管結石的臨床療效。 方法回顧性分析45例行LC＋LCBDE及60例行EST＋LC患者的臨床資料，觀察2組在單次結石清除率、中轉手術率、手術并發癥、住院時間等指標方面的效果。 結果2組患者的基線資料相近，無手術死亡病例；2組術后并發癥發生情況的差異無統計學意義（P＞0.05）；LC＋LCBDE組單次治療成功率高于EST＋LC組，而住院時間及中轉手術率則短于或低于EST＋LC組（P＜0.05）。 結論LC＋LCBDE是治療膽囊結石合并肝外膽管結石患者安全有效的方法。
ObjectiveTo conduct a Meta-analysis to determine the clinical effect of protocol biopsy (PB)-monitored therapy after renal transplantation.MethodsPubMed, Embase, Cochrane Library, Chinese National Knowledge Infrastructure, Wanfang Standards Database and VIP Database for Chinese Technical Periodicals were searched for trials comparing the efficacy of timely intervention under PB surveillance with the conventional treatment. The quality of included studies was assessed and Meta-analysis was conducted by RevMan 5.3 software.ResultsSix randomized controlled trials met our inclusion criteria, including 698 cases. No significant difference was found between the PB group and the control group in 1-year [relative risk (RR)=0.99, 95% confidence interval (CI) (0.97, 1.01), P=0.39] and 2-year recipient survival rate [RR=1.00, 95%CI (0.97, 1.02), P=0.72]. Graft survival rate after 1 year [RR=1.01, 95%CI (0.99, 1.04), P=0.29] and 2 years [RR=1.02, 95%CI (0.99, 1.06), P=0.19] were also statistically similar. No statistical difference was found in glomerular filtration rate between the two groups [mean difference (MD)=0.45 mL/(min·1.73 m2), 95%CI (–3.77, 4.67) mL/(min·1.73 m2), P=0.83]. Renal function of PB group, monitored by serum creatinine, was superior to the control group [MD=–0.46 mg/dL, 95%CI (–0.63, –0.29) mg/dL, P<0.000 01]. No statistical difference was found in infection between the two groups [RR=1.23, 95%CI (0.69, 2.19), P=0.48].ConclusionsOur study did not suggest PB for every kidney transplantation recipient. However, long-term randomized controlled trials with larger sample size would be necessary to determine whether PB was effective for specific populations.