Systematic review and meta-analysis of studies of biliary reconstruction in adult living donor liver transplantation.
Chok KSH and Lo CM.ANZ Journal of Surgery 2017; 87(3): 121-125.
Aims
To conduct a systematic review and meta-analysis to investigate the impact of bile duct reconstruction method in living donor liver transplantation (LDLT) on biliary complications.
Interventions
The database PubMed and Web of Science were searched and all studies on adult LDLT published in English between 1990 and 2014 were considered for review. Papers focusing on bile duct reconstruction method in relation to post-LDLT biliary complication were included.
Participants
Six retrospective studies were included, covering 1286 adult patients.
Outcomes
Primary measured outcomes were the incidence of biliary complications, bilary anastomotic stricture and biliary leakage. Number of recipients, method of bile duct reconstruction (DDA or HJ) and treatment modality were also measured.
Follow-up
Not described
CET Conclusions
The objective of the systematic review was to investigate the impact of the biliary reconstruction method on biliary complications (biliary leakage and biliary strictures) in living donor liver transplantation recipients. The limited bibliographic search using only PubMed and Web of Science retrieved a total of 16 studies. Six retrospective studies met the inclusion criteria. Eligible studies were not critically appraised and there was no description of the data extraction process and whether this was done by two independent reviewers. Of all patients (n=1286) around 70% underwent duct-to-duct anastomosis (DDA), around 28% underwent hepaticojejunostomy (HJ) and <1% underwent both procedures. Meta-analysis showed a lower incidence of biliary strictures for HJ compared to DDA but no difference between procedures for the incidence of biliary leakage. This low quality systematic review offers limited evidence on this topic.
Quality notes
Quality assessment not appropriate
Trial registration
None