{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T14:33:01Z","timestamp":1790260381567,"version":"4.1.0"},"reference-count":54,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2025,6,1]],"date-time":"2025-06-01T00:00:00Z","timestamp":1748736000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Laparoendoscopic &amp; Advanced Surgical Techniques"],"published-print":{"date-parts":[[2025,6,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Laparoscopic common bile duct exploration (LCBDE) is a critical procedure for managing choledocholithiasis, with primary closure (PC) and T-tube drainage (TTD) as common methods for common bile duct closure. However, the substantial number of new studies comparing PC and TTD underscores the need for an updated meta-analysis. Therefore, this study aims to compare surgery-related outcomes in PC and TTD for biliary duct closure following LCBDE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      We searched PubMed, Embase, and Cochrane Library databases on June 20, 2024. Mean differences (MDs) and risk ratios with 95% confidence intervals (CIs) were pooled for continuous and binary outcomes, respectively. Heterogeneity was assessed with\n                      <jats:italic toggle=\"yes\">I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      statistics. Statistical analysis was performed using Software R, version 4.3.3.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 31 studies comprising 4432 patients were included. A total of 2301 (51.9%) were submitted to PC and 2131 (48.1%) were submitted to TTD. The mean age of patients ranged from 39 to 69.8 years and 44.3% were male. Compared with TTD, PC significantly reduced retained stones (odds ratio [OR] 0.57; 95% CI 0.35\u20130.93;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .02;\n                      <jats:italic toggle=\"yes\">I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      = 0%), biliary peritonitis (OR 0.22; 95% CI 0.08\u20130.60;\n                      <jats:italic toggle=\"yes\">P &lt;<\/jats:italic>\n                      .01;\n                      <jats:italic toggle=\"yes\">I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      = 0%), operative time (MD \u221221.07 minutes; 95% CI \u221227.68\u201314.46;\n                      <jats:italic toggle=\"yes\">P &lt;<\/jats:italic>\n                      . 01;\n                      <jats:italic toggle=\"yes\">I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      = 97%) and postoperative hospital stay (MD \u22122.20 days; 95% CI \u22122.80\u20131.60;\n                      <jats:italic toggle=\"yes\">P &lt;<\/jats:italic>\n                      . 01;\n                      <jats:italic toggle=\"yes\">I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      = 96%). However, there were no significant differences between the groups in recurrent stones (OR 0.57; 95% CI 0.32\u20131.02;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .06;\n                      <jats:italic toggle=\"yes\">I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      = 0%), bile leakage (OR 0.89; 95% CI 0.65\u20131.23;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .49;\n                      <jats:italic toggle=\"yes\">I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      = 0%), bile duct stricture (OR 2.08; 95% CI 0.36\u201312.11;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .42;\n                      <jats:italic toggle=\"yes\">I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      = 0%), pneumonia (OR 1.38; 95% CI 0.66\u20132.88;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .39;\n                      <jats:italic toggle=\"yes\">I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      = 0%), and pancreatitis (OR 0.64; 95% CI 0.29\u20131.38;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .25;\n                      <jats:italic toggle=\"yes\">I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      = 0%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>In this meta-analysis, PC was associated with decreased retained stones, biliary peritonitis, operative time, and postoperative hospital stay. However, no significant differences were observed for the other outcomes. These findings underscore PC as a safe and reliable method for bile duct closure following LCBDE.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/lap.2025.0048","type":"journal-article","created":{"date-parts":[[2025,5,5]],"date-time":"2025-05-05T12:45:17Z","timestamp":1746449117000},"page":"463-475","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":8,"title":["Primary Closure Versus T-Tube Drainage on Common Bile Duct Exploration for Choledocholithiasis: An Updated Systematic Review and Meta-Analysis"],"prefix":"10.1177","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-7687-3073","authenticated-orcid":false,"given":"Lucas Monteiro","family":"Delgado","sequence":"first","affiliation":[{"name":"Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2960-3810","authenticated-orcid":false,"given":"Bernardo Fontel","family":"Pompeu","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Heliopolis Hospital, S\u00e3o Paulo, Brazil."},{"name":"Universidade Municipal de S\u00e3o Caetano do Sul (USCS), S\u00e3o Paulo, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6484-1162","authenticated-orcid":false,"given":"Eric","family":"Pasqualotto","sequence":"additional","affiliation":[{"name":"Universidade Federal de Santa Catarina, Florian\u00f3polis, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5783-4083","authenticated-orcid":false,"given":"Gabriel Henrique Acedo","family":"Martins","sequence":"additional","affiliation":[{"name":"Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-4873-3201","authenticated-orcid":false,"given":"Clara de Jesus","family":"Moraes","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Heliopolis Hospital, S\u00e3o Paulo, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-8437-9682","authenticated-orcid":false,"given":"Lucas Soares de Souza Pinto","family":"Guedes","sequence":"additional","affiliation":[{"name":"Universidade Municipal de S\u00e3o Caetano do Sul (USCS), S\u00e3o Paulo, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2986-8164","authenticated-orcid":false,"given":"Sergio Mazzola","family":"Poli de Figueiredo","sequence":"additional","affiliation":[{"name":"Department of Surgery, The University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,6,10]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/MOG.0000000000000418"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1159\/000508874"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hpb.2016.12.011"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1080\/00365521.2016.1224382"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-007-9577-1"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12893-016-0201-y"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1002\/ags3.12668"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1631\/jzus.B2100523"},{"key":"e_1_3_5_10_2","unstructured":"Higgins JPT Thomas J Chandler J et al. 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