BACKGROUND: The purpose of this study was to compare outcomes after duct-to-duct anastomoses with or without biliary T-tube in orthotopic liver transplantation. METHODS: We pooled the outcomes of 1027 patients undergoing choledocho-choledochostomy with or without T-tube in 9 of 46 screened trials by means of fixed or random effects models. RESULTS: The "without T-tube" and "with T-tube" groups had equivalent outcomes for: anastomotic bile leaks or fistulas, choledocho-jejunostomy revisions, dilatation and stenting, hepatic artery thromboses, retransplantation, and mortality due to biliary complications. The "without T-tube" group had better outcomes when considering "fewer episodes of cholangitis," "fewer episodes of peritonitis," and showed a favorable trend for "overall biliary complications." Although the "with T-tube" group showed superior result for "anastomotic and nonanastomotic strictures," the incidence of interventions was not diminished. CONCLUSIONS: Our systematic review and meta analysis favor the abandonment of T-tubes in orthotopic liver transplantation.
BACKGROUND: The purpose of this study was to compare outcomes after duct-to-duct anastomoses with or without biliary T-tube in orthotopic liver transplantation. METHODS: We pooled the outcomes of 1027 patients undergoing choledocho-choledochostomy with or without T-tube in 9 of 46 screened trials by means of fixed or random effects models. RESULTS: The "without T-tube" and "with T-tube" groups had equivalent outcomes for: anastomotic bile leaks or fistulas, choledocho-jejunostomy revisions, dilatation and stenting, hepatic artery thromboses, retransplantation, and mortality due to biliary complications. The "without T-tube" group had better outcomes when considering "fewer episodes of cholangitis," "fewer episodes of peritonitis," and showed a favorable trend for "overall biliary complications." Although the "with T-tube" group showed superior result for "anastomotic and nonanastomotic strictures," the incidence of interventions was not diminished. CONCLUSIONS: Our systematic review and meta analysis favor the abandonment of T-tubes in orthotopic liver transplantation.
Authors: Soon Kyu Lee; Jong Young Choi; Dong Myung Yeo; Young Joon Lee; Seung Kew Yoon; Si Hyun Bae; Jeong Won Jang; Hee Yeon Kim; Dong Goo Kim; Young Kyoung You Journal: World J Gastroenterol Date: 2016-02-21 Impact factor: 5.742
Authors: Pim B Olthof; Robert J S Coelen; Jimme K Wiggers; Marc G H Besselink; Olivier R C Busch; Thomas M van Gulik Journal: HPB (Oxford) Date: 2016-02-18 Impact factor: 3.647
Authors: Gursimran Kochhar; Jose Mari Parungao; Ibrahim A Hanouneh; Mansour A Parsi Journal: World J Gastroenterol Date: 2013-05-21 Impact factor: 5.742