BACKGROUND: Open portoenterostomy (OPE) remains the mainstay in treatment of biliary atresia, while during the past several years, the laparoscopic portoenterostomy (LPE) has been widely introduced. However, safety of LPE remains a major concern. Thus, we conducted a systematic review and meta-analysis to review the currently available data comparing LPE and OPE. DESIGN: Systematic review and meta-analysis. DATA SOURCES: Medline, Ovid, Elsevier, Google Scholar Embase, Cohrane library. STUDY SELECTION: Comparative cohort studies. DATA EXTRACTION: Two investigators independently assessed selected studies and extracted the following information: study characteristics, quality, outcomes data, etc. RESULTS: Eleven studies about the effectiveness of LPE compared with OPE were performed by meta-analysis. Meta-analysis found no significant difference between the two groups in operative time, hospital stay, intraoperative blood loss, early clearance of jaundice, cholangitis and variceal bleeding. In addition, the rate of 2-year survival with native liver was significantly high in OPE group than in LPE group. CONCLUSION: Laparoscopic portoenterostomy could not replace open portoenterostomy and open Kasai portoenterostomy remains the gold standard in the treatment of biliary atresia.
BACKGROUND: Open portoenterostomy (OPE) remains the mainstay in treatment of biliary atresia, while during the past several years, the laparoscopic portoenterostomy (LPE) has been widely introduced. However, safety of LPE remains a major concern. Thus, we conducted a systematic review and meta-analysis to review the currently available data comparing LPE and OPE. DESIGN: Systematic review and meta-analysis. DATA SOURCES: Medline, Ovid, Elsevier, Google Scholar Embase, Cohrane library. STUDY SELECTION: Comparative cohort studies. DATA EXTRACTION: Two investigators independently assessed selected studies and extracted the following information: study characteristics, quality, outcomes data, etc. RESULTS: Eleven studies about the effectiveness of LPE compared with OPE were performed by meta-analysis. Meta-analysis found no significant difference between the two groups in operative time, hospital stay, intraoperative blood loss, early clearance of jaundice, cholangitis and variceal bleeding. In addition, the rate of 2-year survival with native liver was significantly high in OPE group than in LPE group. CONCLUSION: Laparoscopic portoenterostomy could not replace open portoenterostomy and open Kasai portoenterostomy remains the gold standard in the treatment of biliary atresia.
Authors: David Eugenio Hinojosa-Gonzalez; Luis C Bueno; Andres Roblesgil-Medrano; Gustavo Salgado-Garza; Sofia Hurtado-Arellano; Juan S Farias; Mauricio Torres-Martinez; Jaime A Escarcega-Bordagaray; Marcelo Salan-Gomez; Eduardo Flores-Villalba Journal: Pediatr Surg Int Date: 2021-07-16 Impact factor: 1.827