Biliary reconstructions in 150 orthotopic liver transplantations: an experience with three techniques

Leonardi, Luiz Sérgio; Boin, I.F.S.F.; Neto, Francisco Callejas; Oliveira, Gustavo R.; Leonardi, M.I.

doi:10.1016/s0041-1345(02)02784-7

Cited by 7 publications

(8 citation statements)

References 20 publications

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“…The article analysis identified three randomized clinical trials [11, 13, 14], six clinical trials [5, ], and 48 historical cohort studies (Table 2) [1, ].…”

Section: Resultsmentioning

confidence: 99%

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Systematic review and meta‐analysis of biliary reconstruction techniques in orthotopic deceased donor liver transplantation

Paes-Barbosa

Massarollo

Bernardo

et al. 2010

J Hepato Biliary Pancreat

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Background Biliary complications remain a major cause of morbidity and mortality in liver transplantation and the biliary anastomosis technique could increase this risk. The aim of this study was to compare the effects of biliary reconstruction techniques in orthotopic liver transplantation on the incidence of biliary complications. Methods A systematic review and meta-analysis using the Medline-PubMed, EMBASE, Scielo-LILACS, and Cochrane Databases were performed comparing biliary reconstruction techniques in liver transplantation with regard to the occurrence of biliary complications. Number needed to treat (NNT) was calculated at a 95% confidence interval.Results Fifty-seven articles were selected (3 randomized clinical trials, 6 clinical trials, and 48 historical cohort studies). There was a lower risk for biliary complications (NNT = 6) using end-to-end choledochocholedochostomy (EECC) without drainage compared with EECC with drainage. The biliary complication risk was lower (NNT = 4) for sideto-side choledochocholedochostomy (SSCC) with drainage compared with SSCC without drainage. No difference was found between EECC without drainage and SSCC with drainage. Conclusions According to our results, considering the highest level of evidence available in the literature, we suggest that biliary reconstruction in liver transplantation should be performed using EECC or SSCC, without drainage in the former, and with drainage in the latter.

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“…The article analysis identified three randomized clinical trials [11, 13, 14], six clinical trials [5, ], and 48 historical cohort studies (Table 2) [1, ].…”

Section: Resultsmentioning

confidence: 99%

“…The meta‐analysis calculation was possible only for the EECCwoD × EECCwD comparison for clinical trials and historical cohort studies [1, , 29, 31, 32, 34, , , 50, 51, 56, 61] which originally made this comparison.…”

Section: Resultsmentioning

confidence: 99%

Systematic review and meta‐analysis of biliary reconstruction techniques in orthotopic deceased donor liver transplantation

Paes-Barbosa

Massarollo

Bernardo

et al. 2010

J Hepato Biliary Pancreat

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“…HJS might serve as surgical alternative to ERC interventions for biliary obstruction. The establishment of a bilioenteric diversion is performed as primary re‐establishment of the biliary continuity in some patients with pre‐existing biliary tract diseases as sclerosing cholangitis, in case of extensive discrepancy in the sizes of donor and recipient bile ducts and sometimes in re‐transplantation (9, 21). Necrosis of the bile duct, extensive biliary leakage, when a direct re‐anastomosis of the common bile duct is not feasible or in persisting biliary leakage after placement of a bile duct stent (35) are well established indications for HJS following liver transplantation.…”

Section: Discussionmentioning

confidence: 99%

“…Since the beginning of liver transplantation, the reconstruction of the biliary continuity has been considered the technical “Achilles heal” of this procedure (16). Because of the improved surgical and preservation techniques, the incidence of biliary tract complications after liver transplantation has decreased in the last decades, but is still reported to occur in 12–30% (17–22).…”

Section: Discussionmentioning

confidence: 99%

Outcome of hepaticojejunostomy for biliary tract obstruction following liver transplantation

Langer

Györi

Pokorny

et al. 2009

Clinical Transplantation

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“…It is well known that biliary complications are still a major cause of long‐term morbidity after LT 7–10 . In addition to technical and vascular issues leading to biliary complications, surgeons have debated whether or not using a T‐tube is contributing to or reducing the occurrence of these complications 11–14 . There have been many single‐center reports and meta‐analyses on the subject 15–18 .…”

Section: Introductionmentioning

confidence: 99%

The role of T‐tubes and abdominal drains on short‐term outcomes in liver transplantation – A systematic review of the literature and expert panel recommendations

Kalisvaart

Jonge

Abt

et al. 2022

Clinical Transplantation

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Background: This systematic review and expert panel recommendation aims to answer the question regarding the routine use of T-tubes or abdominal drains to better manage complications and thereby improve outcomes after liver transplantation.Methods: Systematic review following PRISMA guidelines and recommendations using the GRADE approach derived from an international expert panel to assess the potential risks and benefits of T-tubes and intra-abdominal drainage in liver transplantation (CRD42021243036).Results: Of the 2996 screened records, 33 studies were included in the systematic review, of which 29 (six RCTs) assessed the use of T-tubes and four regarding surgical drains. Although some studies reported less strictures when using a T-tube, there was a trend toward more biliary complications with T-tubes, mainly related to biliary leakage. Due to the small number of studies, there was a paucity of evidence on the effect of abdominal drains with no clear benefit for or against the use of drainage. However, This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

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Biliary reconstructions in 150 orthotopic liver transplantations: an experience with three techniques

Cited by 7 publications

References 20 publications

Systematic review and meta‐analysis of biliary reconstruction techniques in orthotopic deceased donor liver transplantation

Systematic review and meta‐analysis of biliary reconstruction techniques in orthotopic deceased donor liver transplantation

Outcome of hepaticojejunostomy for biliary tract obstruction following liver transplantation

The role of T‐tubes and abdominal drains on short‐term outcomes in liver transplantation – A systematic review of the literature and expert panel recommendations

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