Orthotopic liver transplantation: T-tube or not T-tube? Systematic review and meta-analysis of results.
| Title | Orthotopic liver transplantation: T-tube or not T-tube? Systematic review and meta-analysis of results. |
| Publication Type | Journal Article |
| Year of Publication | 2009 |
| Authors | Sotiropoulos, G. C., Sgourakis G., Radtke A., Molmenti E. P., Goumas K., Mylona S., Fouzas I., Karaliotas C., & Lang H. |
| Journal | Transplantation |
| Volume | 87 |
| Issue | 11 |
| Pagination | 1672-80 |
| Date Published | 2009 Jun 15 |
| ISSN | 1534-6080 |
| Keywords | Anastomosis, Surgical, Choledochostomy, Disease Progression, Female, Gallbladder Diseases, Humans, Liver Transplantation, Male, Odds Ratio, Peritonitis, Postoperative Complications, Practice Guidelines as Topic, Quality Assurance, Health Care, Retrospective Studies |
| Abstract | 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. |
| DOI | 10.1097/TP.0b013e3181a5cf3f |
| Alternate Journal | Transplantation |
| PubMed ID | 19502959 |
