中文摘要：

目的探讨胆囊-空肠吻合术（CCE）与胆管-空肠吻合术（CDE）治疗不可切除胰头癌所致梗阻性黄疸的价值。方法检索1980年1月至2016年1月Cochrane、Pub Med、EBASE、Ovid、Springer、CNKI、万方、维普数据库。英文检索词：pancreatic cancer、pancreatic neoplasms、pancreatic tumor、cholecystoenterostomy、choledochoenterostomy、biliary bypass、palliative surgery。中文检索词：胰腺癌、胰腺肿瘤、胆囊-空肠吻合术、胆管-空肠吻合术、胆道转流术、姑息手术。将文献中患者分为CCE组和CDE组,对两组黄疸复发率、围手术期死亡率、术后并发症发生率等结局指标进行Meta分析。结果经筛选后共有12篇文献纳入Meta分析,其中随机对照试验文献2篇,回顾性研究文献10篇。Meta分析结果显示,CCE组黄疸复发率明显高于CDE组（OR=5.00,95%CI：3.12~8.03;P〈0.05）。CCE组中位生存时间明显短于CDE组（SMD=-1.96,95%CI：-2.30~-1.62;P〈0.05）。CCE组围手术期死亡率明显高于CDE组（OR=1.90,95%CI：1.56~2.23;P〈0.05）。结论治疗不可切除胰头癌所致的胆道梗阻,与CCE比较,CDE具有黄疸复发率低,围手术期死亡率低,生存时间长等优势。

英文摘要：

Objective To investigate the efficacy of cholecystoenterostomy（CCE） and choledochoenterostomy（CDE） for obstructive jaundice caused by unresectable pancreatic head carcinoma.Methods Literature from the Cochrane,Pub Med,EMBASE,Ovid,Springer,CNKI,WANFANG,VIP databases between January 1980 and January 2016 was searched.The search terms were pancreatic cancer,pancreatic neoplasms,pancreatic tumor,cholecystoenterostomy,choledochoenterostomy,biliary bypass and palliative surgery,both in Chinese and English.The patients from the literature were divided into the CCE group and CDE group.The outcome indicators including recurrence rate of jaundice,perioperative mortality and incidence of postoperative complications in two groups were analyzed using the Meta-analysis.Results A total of 12 literatures were included after screening,including two reports of random controlled trials and 10 retrospective studies.The meta-analysis results revealed that the recurrence rate of jaundice in the CCE group was significantly higher than that in the CDE group（OR=5.00,95%CI：3.12-8.03;P〈0.05）.The median survival time in the CCE group was signifi cantly shorter than that in the CDE group（SMD=-1.96,95%CI：-2.30--1.62;P〈0.05）.The perioperative mortality in the CCE group was signifi cantly higher than that in the CDE group（OR=1.90,95%CI：1.56-2.23;P〈0.05）.Conclusion Compared with CCE,CDE has the advantages of lower recurrence rate of jaundice,lower perioperative mortality and longer survival time in treating obstrucive jaundice caused by unresectable pancreatic head carcinoma.