Supplemental Digital Content is available in the text

No abstract

No abstract

ObjectivesThe optimal treatment strategy for cholecystocholedocholithiasis is still controversial. We conducted an up-to-date meta-analysis to compare the efficacy and safety of the intra- endoscopic retrograde cholangiopancreatography (ERCP) + LC procedure with the traditional pre-ERCP +  laparoscopic cholecystectomy (LC) procedure in the management of cholecystocholedocholithiasis.MethodsWe searched the PubMed, Embase, Cochrane Library, and Web of Science databases up to September 2020. Published randomized controlled trials comparing intra-ERCP + LC and pre-ERCP + LC were considered. This meta-analysis was performed by Review Manager Version 5.3, and outcomes were documented by pooled risk ratio (RR) and mean difference (MD) with 95% confidence intervals.ResultsEight studies with a total of 977 patients were included in this meta-analysis. There was no significant difference between the two groups regarding CBD stone clearance (RR = 1.03, P = .27), postoperative papilla bleeding (RR = 0.41, P = .13), postoperative cholangitis (RR = 0.87, P = .79), and operation conversion rate (RR = 0.71, P = .26). The length of hospital stay was shorter in the intra-ERCP + LC group (MD = −2.75, P < .05), and intra-ERCP + LC was associated with lower overall morbidity (RR = 0.54, P < .05), postoperative pancreatitis (RR = 0.29, P < .05) and cannulation failure rate (RR = 0.22, P < .05).ConclusionsIntra-ERCP + LC was a safer approach for patients with cholecystocholedocholithiasis. It could facilitate intubation, shorten hospital stay, and lower postoperative complications, especially postoperative pancreatitis, and reduce stone residue and reduce the possibility of reoperation for stone removal.

Background: There is no robust biological marker for the diagnosis of Parkinson's disease, and most of them are diagnosed until motor symptoms develop, which may affect the early intervention and prognosis Objective: To evaluate the diagnostic value of different parameter values of DTI in PD.Methods and analysis: We will systematically search the cochrane, pubmed, and embase databases, but we only consider observational studies and English studies. The main outcomes are DTI parameters, including FA, MDC, and ADC. We will evaluate the quality of the included studies through the NOS scale, and the data synthesis will be analyzed by revman5.3.Discussion: This systematic review will integrate all relevant DTI observation results on PD imaging, and evaluate whether DTI can be used as a biological marker for the diagnosis of PD. The review results will provide a useful reference for the diagnosis of PDSystematic review registration: The protocol has been registered at the International Platform of Registered Systematic Review and Meta-analysis Protocols(INPLASY202070098).