Laparoscopic versus open portoenterostomy for treatment of biliary atresia: a meta-analysis
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In brief
In brief
This meta-analysis of 23 studies comparing laparoscopic versus open portoenterostomy for biliary atresia found that laparoscopic approach reduces blood loss and time to feeding, though operative time is longer. No significant differences were observed in complication rates, jaundice clearance, or two-year transplant-free survival between techniques.
Written by the GCMD Library team from the article.
Abstract
Objective
Our goal was to compare laparoscopic portoenterostomy versus open portoenterostomy for the treatment of biliary atresia.
Materials and methods
Using the databases EMBASE, PubMed, and Cochrane, we carried out a thorough literature search up to 2022. Studies comparing laparoscopic and open surgery for the treatment of biliary atresia were included.
Results
Twenty-three studies comparing laparoscopic portoenterostomy (LPE) (n = 689) and open portoenterostomy (OPE) (n = 818) were considered appropriate for meta-analysis. Age at surgery time was lower in the LPE group than OPE group (I2 = 84%), (WMD − 4.70, 95% CI − 9.14 to − 0.26; P = 0.04). Significantly decreased blood loss (I2 = 94%), (WMD − 17.85, 95% CI − 23.67 to − 12.02; P < 0.00001) and time to feed were found in the laparoscopic group (I2 = 97%), (WMD − 2.88, 95% CI − 4.71 to − 1.04; P = 0.002). Significantly decreased operative time was found in the open group (I2 = 85%), (WMD 32.52, 95% CI 15.65–49.39; P = 0.0002). Weight, transfusion rate, overall complication rate, cholangitis, time to drain removal, length of stay, jaundice clearance, and two-year transplant-free survival were not significantly different across the groups.
Conclusions
Laparoscopic portoenterostomy provides advantages regarding operative bleeding and the time to begin feeding. No differences in remain characteristics. Based on the data presented to us by this meta-analysis, LPE is not superior to OPE in terms of overall results.