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T-tube vs no T-tube for biliary tract reconstruction in adult orthotopic liver transplantation:An updated systematic review and metaanalysis

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World Journal of Gastroenterology 2021年第14期27卷 1507-1523页

作者： Jun-Zhou Zhao Lin-Lan Qiao Zhao-Qing Du Jia Zhang Meng-Zhou Wang Tao Wang Wu-Ming Liu Lin Zhang Jian Dong Zheng Wu Rong-Qian Wu Department of Hepatobiliary Surgery First Affiliated Hospital of Xi’an Jiaotong UniversityXi’an 710061Shaanxi ProvinceChina National Local Joint Engineering Research Center for Precision Surgery and Regenerative Medicine First Affiliated Hospital of Xi’an Jiaotong UniversityXi’an 710061Shaanxi ProvinceChina

BACKGROUND Whether to use a T-tube for biliary anastomosis during orthotopic liver transplantation(OLT)remains a debatable *** surgeons chose to use a T-tube because they believed that it reduces the incidence of biliary *** in surgical techniques during the last decades have significantly decreased the overall incidence of postoperative biliary *** using a T-tube during OLT is still associated with the reduced incidence of biliary strictures needs to be *** To provide an updated systematic review and meta-analysis on using a T-tube during adult *** In the electronic databases MEDLINE,PubMed,Scopus,***,the Cochrane Library,the Cochrane Hepato-biliary Group Controlled Trails Register,and the Cochrane Central Register of Controlled Trials,we identified 17 studies(eight randomized controlled trials and nine comparative studies)from January 1995 to October *** data of the studies before and after 2010 were separately *** chose the overall biliary complications,bile leaks or fistulas,biliary strictures(anastomotic or non-anastomotic),and cholangitis as *** ratios(ORs)with 95%confidence intervals(CIs)were calculated to describe the results of the ***,the test for overall effect(Z)was used to test the difference between OR and 1,where P≤0.05 indicated a significant difference between OR value and *** A total of 1053 subjects before 2010 and 1346 subjects after 2010 were included in this *** pooled results showed that using a T-tube reduced the incidence of postoperative biliary strictures in studies before 2010(P=0.012,OR=0.62,95%CI:0.42-0.90),while the same benefit was not seen in studies after 2010(P=0.60,OR=0.76,95%CI:0.27-2.12).No significant difference in the incidence of overall biliary complications(P=0.37,OR=1.41,95%CI:0.66-2.98),bile leaks(P=0.89,OR=1.04,95%CI:0.63-1.70),and cholangitis(P=0.27,OR=2.00,95%CI:0.59-6.84)was obse

关键词： Orthotopic liver transplantation T-tube biliary tract reconstruction biliary complications biliary strictures Meta-analysis

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