A meta-analysis of the biliary complications in adult living donor liver transplantation to compare duct-to-duct hepaticocholedochostomy with Roux-en-Y hepaticojejunostomy biliary reconstruction / 中华肝胆外科杂志

ABSTRACT

Objective To compare the incidences of biliary complication after adult living donor liver transplantation (ALDLT) using Roux-en-Y hepaticojejunostomy (R-Y HJ) with duct-to-duct hepaticocholedochostomy (D-D HC).Methods A meta-analysis was conducted by searching the Medline-PubMed,EMBASE,Scielo-LILACS,and Cochrane Databases.A comparison using 95％ confidence intervals was performed on different biliary reconstruction techniques in liver transplantation with regard to occurrence of biliary complications.Results According to our predetermined inclusion and exclusion criteria,seven clinical studies were selected to compare D-D HC with R-Y HJ.The overall biliary comphcation rates,biliary stricture rates and biliary leakage rates were compared.The overall biliary complication rate and the biliary stricture rate of R-Y HJ were significantly less than D-D HC,but the biliary leakage rate of R-Y HJ was similar with the D-D HC (overall biliary complication rate P ＜ 0.05,OR =0.35,95％ CI0.15 ～ 0.81,I2 =28％ ; biliary stricture rate P ＜ 0.05,OR =0.43,95％ CI0.29 ～ 0.65,I2 =49％ ; biliary leakage rate P=0.05,OR=1.62,95％ CI1.01 ～2.60,I2 =19％).Conclusions The meta-analysis showed that biliary reconstruction in ALDLT should be performed using R-Y HJ.