Full Text:   <2045>

CLC number: R657.3

On-line Access: 2011-05-06

Received: 2011-02-27

Revision Accepted: 2011-03-29

Crosschecked: 2011-03-11

Cited: 11

Clicked: 4277

Citations:  Bibtex RefMan EndNote GB/T7714

-   Go to

Article info.
1. Reference List
Open peer comments

Journal of Zhejiang University SCIENCE B 2011 Vol.12 No.5 P.357-364

http://doi.org/10.1631/jzus.B1100054


Value of T-tube in biliary tract reconstruction during orthotopic liver transplantation: a meta-analysis


Author(s):  Wei-dong Huang, Jiu-kun Jiang, Yuan-qiang Lu

Affiliation(s):  Department of Emergency, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China

Corresponding email(s):   luyuanqiang@yahoo.cn

Key Words:  Liver transplantation, Drainage, Biliary tract, Meta-analysis, T-tube


Wei-dong Huang, Jiu-kun Jiang, Yuan-qiang Lu. Value of T-tube in biliary tract reconstruction during orthotopic liver transplantation: a meta-analysis[J]. Journal of Zhejiang University Science B, 2011, 12(5): 357-364.

@article{title="Value of T-tube in biliary tract reconstruction during orthotopic liver transplantation: a meta-analysis",
author="Wei-dong Huang, Jiu-kun Jiang, Yuan-qiang Lu",
journal="Journal of Zhejiang University Science B",
volume="12",
number="5",
pages="357-364",
year="2011",
publisher="Zhejiang University Press & Springer",
doi="10.1631/jzus.B1100054"
}

%0 Journal Article
%T Value of T-tube in biliary tract reconstruction during orthotopic liver transplantation: a meta-analysis
%A Wei-dong Huang
%A Jiu-kun Jiang
%A Yuan-qiang Lu
%J Journal of Zhejiang University SCIENCE B
%V 12
%N 5
%P 357-364
%@ 1673-1581
%D 2011
%I Zhejiang University Press & Springer
%DOI 10.1631/jzus.B1100054

TY - JOUR
T1 - Value of T-tube in biliary tract reconstruction during orthotopic liver transplantation: a meta-analysis
A1 - Wei-dong Huang
A1 - Jiu-kun Jiang
A1 - Yuan-qiang Lu
J0 - Journal of Zhejiang University Science B
VL - 12
IS - 5
SP - 357
EP - 364
%@ 1673-1581
Y1 - 2011
PB - Zhejiang University Press & Springer
ER -
DOI - 10.1631/jzus.B1100054


Abstract: 
Objective: To compare biliary complications after biliary tract reconstruction with or without t-tube in orthotopic liver transplantation. Methods: Randomized control trials (RCTs) and comparative studies were identified by a computerized literature search of the Cochrane Library, MEDLINE (1966/1–2010/4), Scopus (1980/1–2010/4), ClinicalTrials.gov (2010/4), the Cochrane Hepato-Biliary Group Controlled Trials Register, and the Cochrane Central Register of Controlled Trials. Studies and data were extracted and assessed independently. Dichotomous outcomes were reported as odds ratios (ORs) and weighted mean difference with 95% confidence intervals (CI). Results: Five RCTs and eight comparative studies with a total of 1 608 subjects were identified. The data showed that the operation with t-tube had better outcomes for duct stenosis (P=0.01, OR=0.45, 95% CI 0.24–0.85). The operations with or without t-tube had equivalent outcomes as follows: overall biliary complications (P=0.85, OR=1.15, 95% CI 0.28–4.72), bile leaks (P=0.38, OR=0.75, 95% CI 0.39–1.42), and cholangitis (P=0.24, OR=4.64, 95% CI 0.36–60.62). These results were strengthened by the analysis of all thirteen non-randomized and randomized studies. Conclusions: Our systematic review and meta-analysis suggest that the insertion of a t-tube reduces the incidence of biliary stenosis without increasing the incidence of other biliary complications.

Darkslateblue:Affiliate; Royal Blue:Author; Turquoise:Article

Reference

[1]Amador, A., Charco, R., Marti, J., Alvarez, G., Ferrer, J., Mans, E., Fuster, J., Fondevila, C., Garcia-Valdecasas, J.C., 2005. Cost/efficacy clinical trial about the use of T-tube in cadaveric donor liver transplant: preliminary results. Transplant. Proc., 37(2):1129-1130.

[2]Amador, A., Charco, R., Marti, J., Navasa, M., Rimola, A., Calatayud, D., Rodriguez-Laiz, G., Ferrer, J., Romero, J., Ginesta, C., 2007. Clinical trial on the cost-effectiveness of T-tube use in an established deceased donor liver transplantation program. Clin. Transplant., 21(4):548-553.

[3]Biondi-Zoccai, G.G., Agostoni, P., Abbate, A., Testa, L., Burzotta, F., 2005. A simple hint to improve Robinson and Dickersin’s highly sensitive PubMed search strategy for controlled clinical trials. Int. J. Epidemiol., 34(1):224-225.

[4]Castaldo, E.T., Pinson, C.W., Feurer, I.D., Wright, J.K., Gorden, D.L., Kelly, B.S., Chari, R.S., 2007. Continuous versus interrupted suture for end-to-end biliary anastomosis during liver transplantation gives equal results. Liver Transpl., 13(2):234-238.

[5]Cozzi, G., Colella, G., Bellomi, M., Colnago, M.F., Salvetti, M., Regalia, E., Mazzaferro, V., Severini, A., 1995. Use of safety catheter after removal of Kehr’s tube in liver transplant patients. Radiol. Med., 89(1-2):91-93.

[6]Davidson, B.R., Rai, R., Kurzawinski, T.R., Selves, L., Farouk, M., Dooley, J.S., Burroughs, A.K., Rolles, K., 1999. Prospective randomized trial of end-to-end versus side-to-side biliary reconstruction after orthotopic liver transplantation. Br. J. Surg., 86(4):447-452.

[7]de Simone, P., Urbani, L., Morelli, L., Catalano, G., Coletti, L., Spampinato, M., Filipponi, F., Campatelli, A., 2005. The T-tube approach to biliary strictures in liver transplant recipients. Transplantation, 79(2):254-255.

[8]Duailibi, D.F., Ribeiro, M.A.Jr, 2010. Biliary complications following deceased and living donor liver transplantation: a review. Transplant. Proc., 42(2):517-520.

[9]Ferraz-Neto, B.H., Mirza, D.F., Gunson, B.K., Ismail, T., Mayer, A.D., Buckels, J.A., McMaster, P., 1996. Bile duct splintage in liver transplantation: is it necessary? Transpl. Int., 9(s1):S185-S187.

[10]Higgins, J.P., Thompson, S.G., Deeks, J.J., Altman, D.G., 2003. Measuring inconsistency in meta-analyses. BMJ, 327(7414):557-560.

[11]Lau, J., Ioannidis, J.P., Schmid, C.H., 1997. Quantitative synthesis in systematic reviews. Ann. Intern. Med., 127(9):820-826.

[12]Lerut, J., Gordon, R.D., Iwatsuki, S., Starzl, T.E., 1987. Surgical complications in human orthotopic liver transplantation. Acta Chir. Belg., 87(3):193-204.

[13]Li, T., Chen, Z.S., Zeng, F.J., Ming, C.S., Zhang, W.J., Liu, D.G., Jiang, J.P., Du, D.F., Klaus Chen, Z.H., 2007. Impact of early biliary complications in liver transplantation in the presence or absence of a T-tube: a Chinese transplant centre experience. Postgrad. Med. J., 83(976):120-123.

[14]Liao, J.Z., Zhao, Q., Qin, H., Li, R.X., Hou, W., Li, P.Y., Liu, N.Z., Li, D.M., 2007. Endoscopic diagnosis and treatment of biliary leak in patients following liver transplantation: a prospective clinical study. Hepatobiliary Pancreat. Dis. Int., 6(1):29-33.

[15]Lin, C.H., Yu, J.C., Chen, T.W., Chuang, C.H., Tsai, Y.C., Chen, S.Y., Hsieh, C.B., 2007. The experience of biliary tract complications after liver transplantation. Transplant. Proc., 39(10):3251-3260.

[16]Nuño, J., Vicente, E., Turrion, V.S., Pereira, F., Ardaiz, J., Cuervas, V., Barcena, R., Garcia, M., San Roman, A.L., Candela, A., 1997. Biliary tract reconstruction after liver transplantation: with or without T-tube? Transplant. Proc., 29(1-2):564-565.

[17]Qin, Y.S., Li, Z.S., Sun, Z.X., Wu, R.P., Wang, N., Yao, Y.Z., 2006. Endoscopic management of biliary complications after orthotopic liver transplantation. Hepatobiliary Pancreat. Dis. Int., 5(1):39-42.

[18]Rabkin, J.M., Orloff, S.L., Reed, M.H., Wheeler, L.J., Corless, C.L., Benner, K.G., Flora, K.D., Rosen, H.R., Olyaei, A.J., 1998. Biliary tract complications of side-to-side without T tube versus end-to-end with or without T tube choledochocholedochostomy in liver transplant recipients. Transplantation, 65(2):193-199.

[19]Randall, H.B., Wachs, M.E., Somberg, K.A., Lake, J.R., Emond, J.C., Ascher, N.L., Roberts, J.P., 1996. The use of the T tube after orthotopic liver transplantation. Transplantation, 61(2):258-261.

[20]Rolles, K., Dawson, K., Novell, R., Hayter, B., Davidson, B., Burroughs, A., 1994. Biliary anastomosis after liver transplantation does not benefit from T tube splintage. Transplantation, 57(3):402-404.

[21]Rouch, D.A., Emond, J.C., Thistlethwaite, J.R.Jr, Mayes, J.T., Broelsch, C.E., 1990. Choledochocholedochostomy without a T tube or internal stent in transplantation of the liver. Surg. Gynecol. Obstet., 170(3):239-244.

[22]Scatton, O., Meunier, B., Cherqui, D., Boillot, O., Sauvanet, A., Boudjema, K., Launois, B., Fagniez, P.L., Belghiti, J., Wolff, P., et al., 2001. Randomized trial of choledochocholedochostomy with or without a T tube in orthotopic liver transplantation. Ann. Surg., 233(3):432-437.

[23]Shaked, A., 1997. Use of T tube in liver transplantation. Liver Transpl. Surg., 3(5 Suppl. 1):22-23.

[24]Shimoda, M., Saab, S., Morrisey, M., Ghobrial, R.M., Farmer, D.G., Chen, P., Han, S.H., Bedford, R.A., Goldstein, L.I., Martin, P., et al., 2001. A cost-effectiveness analysis of biliary anastomosis with or without T-tube after orthotopic liver transplantation. Am. J. Transplant., 1(2):157-161.

[25]Sotiropoulos, G.C., Sgourakis, G., Radtke, A., Molmenti, E.P., Goumas, K., Mylona, S., Fouzas, I., Karaliotas, C., Lang, H., 2009. Orthotopic liver transplantation: T-tube or not T-tube? Systematic review and meta-analysis of results. Transplantation, 87(11):1672-1680.

[26]Tan, J.W., Jiang, Y., Yao, H.X., Lu, L.Z., Zhang, S.G., 2003. Early prevention and treatment of biliary tract complications after orthotopic liver transplantation. Hepatobiliary Pancreat. Dis. Int., 2(1):48-53.

[27]Urbani, L., Campatelli, A., Romagnoli, J., Catalano, G., Sartoni, G., Costa, A., Vignali, C., Mosca, F., Filipponi, F., 2002. T-tube removal after liver transplantation: a new technique that reduces biliary complications. Transplantation, 74(3):410-413.

[28]Verdonk, R.C., Buis, C.I., Porte, R.J., van der Jagt, E.J., Limburg, A.J., van den Berg, A.P., Slooff, M.J., Peeters, P.M., de Jong, K.P., Kleibeuker, J.H., et al., 2006. Anastomotic biliary strictures after liver transplantation: causes and consequences. Liver Transpl., 12(5):726-735.

[29]Vougas, V., Rela, M., Gane, E., Muiesan, P., Melendez, H.V., Williams, R., Heaton, N.D., 1996. A prospective randomised trial of bile duct reconstruction at liver transplantation: T tube or no T tube? Transpl. Int., 9(4):392-395.

[30]Weiss, S., Schmidt, S.C., Ulrich, F., Pascher, A., Schumacher, G., Stockmann, M., Puhl, G., Guckelberger, O., Neumann, U.P., Pratschke, J., et al., 2009. Biliary reconstruction using a side-to-side choledochocholedochostomy with or without T-tube in deceased donor liver transplantation: a prospective randomized trial. Ann. Surg., 250(5):766-771.

[31]Welling, T.H., Heidt, D.G., Englesbe, M.J., Magee, J.C., Sung, R.S., Campbell, D.A., Punch, J.D., Pelletier, S.J., 2008. Biliary complications following liver transplantation in the model for end-stage liver disease era: effect of donor, recipient, and technical factors. Liver Transpl., 14(1):73-80.

[32]Wojcicki, M., Milkiewicz, P., Silva, M., 2008. Biliary tract complications after liver transplantation: a review. Dig. Surg., 25(4):245-257.

Open peer comments: Debate/Discuss/Question/Opinion

<1>

Please provide your name, email address and a comment





Journal of Zhejiang University-SCIENCE, 38 Zheda Road, Hangzhou 310027, China
Tel: +86-571-87952783; E-mail: cjzhang@zju.edu.cn
Copyright © 2000 - 2022 Journal of Zhejiang University-SCIENCE