Summary of findings 3. LC + LCBDE compared to LC + post‐operative ERCP for common bile duct stones.
| LC + LCBDE compared withLC + post‐operativeERCP for common bile duct stones | ||||||
| Patient or population: with common bile duct stones Settings: secondary or tertiary hospital Intervention: LC + LCBDE Comparison: LC + postoperative ERCP | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of Participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| LC + post‐operativeERCP | LC + LCBDE | |||||
| Total morbidity | Study population | OR 1.16 (0.5 to 2.72) | 166 (2 studies) | ⊕⊕⊕⊝ moderate1,2 | ||
| 141 per 1000 | 160 per 1000 (76 to 309) | |||||
| Moderate | ||||||
| 142 per 1000 | 161 per 1000 (76 to 310) | |||||
| Failure of procedure | Study population | OR 0.47 (0.21 to 1.06) | 166 (2 studies) | ⊕⊕⊕⊝ moderate2 | ||
| 247 per 1000 | 134 per 1000 (64 to 258) | |||||
| Moderate | ||||||
| 247 per 1000 | 134 per 1000 (64 to 258) | |||||
| Retained stones after primary intervention | Study population | OR 0.28 (0.11 to 0.72) | 166 (2 studies) | ⊕⊕⊕⊝ moderate2 | ||
| 247 per 1000 | 84 per 1000 (35 to 191) | |||||
| Moderate | ||||||
| 247 per 1000 | 84 per 1000 (35 to 191) | |||||
| Conversion to open surgery | Study population | OR 1.77 (0.23 to 13.81) | 166 (2 studies) | ⊕⊕⊕⊝ moderate2 | ||
| 12 per 1000 | 21 per 1000 (3 to 141) | |||||
| Moderate | ||||||
| 11 per 1000 | 19 per 1000 (3 to 133) | |||||
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; OR: Odds ratio; | ||||||
| GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate. | ||||||
1Rhodes 1998 is considered to be at unclear risk of bias at randomisation. 2Nathanson 2005 randomised participants with ductal stones at laparoscopic cholecystectomy after failed transcystic clearance to laparoscopic choledochotomy or postoperative ERCP.