Laparoscopic vs open portoenterostomy in biliary atresia: a systematic review and meta-analysis
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Read the article on pubmed.ncbi.nlm.nih.gov ↗Article · Jan 1970 · 1 min read
In brief
In brief
Meta-analysis of 19 studies comparing laparoscopic versus open portoenterostomy for biliary atresia shows laparoscopic approach has longer operative time but reduced bleeding and faster return to normal diet. Both techniques demonstrate equivalent outcomes for complications, cholangitis rates, and transplant-free survival.
Written by the GCMD Library team from the article.
Hepatoportoenterostomy remains the cornerstone of treatment for biliary atresia. Current employed techniques include laparoscopy and open surgery. This study aims to determine if either method provides an advantage. Following PRISMA guidelines, a systematic review was conducted. Nineteen studies were included. Mean operative time 34.98 (95% CI 20.10, 49.85; p ≤ 0.00001) was longer in laparoscopic while bleeding volumes - 16.63 (95% CI - 23.39, - 9.86; p ≤ 0.00001) as well as the time to normal diet - 2.42 (95% CI - 4.51, - 0.32; p = 0.02) were lower in the laparoscopic group. No differences were observed in mean length of stay - 0.83. Similar complication, transfusions, postoperative cholangitis 0.97, and transplant free survival rates 1.00 (0.63, 1.60; p = 0.99) were seen between groups. Laparoscopic portoenterostomy provides advantages on operative time and bleeding as well as to normal diet when compared to open procedures. Both procedures showed no differences in length of stay, complications, cholangitis, and importantly, native liver survival. Level of evidence: III.
DOI:10.1007/s00383-021-04964-5