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Meta-analysis of Duct-to-duct versus Roux-en-Y biliary reconstruction following liver transplantation for primary sclerosing cholangitis

Lookup NU author(s): Sanjay PandanaboyanaORCiD


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© 2015 Steunstichting ESOT.Summary This meta-analysis aimed to compare outcomes following bile duct reconstruction in patients with primary sclerosing cholangitis (PSC) undergoing liver transplantation depending on whether duct-to-duct or Roux-en-Y anastomosis was utilized. An electronic search was performed of the MEDLINE, EMBASE, PubMed databases using both subject headings (MeSH) and truncated word searches. Pooled risk ratios and mean difference were calculated using the fixed-effects and random-effects models for meta-analysis. Ten studies including 910 patients met the inclusion criteria. There was no difference in the overall incidence of biliary strictures between the two groups [odds ratio (OR) 1.06 (0.68, 1.66); (P = 0.80)]. The anastomotic stricture rate was similar, [OR 1.18 (0.56, 2.50); (P = 0.67)]. Ascending cholangitis was higher in the Roux-en-Y group [OR 2.91 (1.17, 7.23); (P = 0.02)]. Anastomotic bile leak rates, graft survival, PSC recurrence and number of patients diagnosed with cholangiocarcinoma following transplantation were comparable between both groups. Duct-to-duct and Roux-en-Y reconstruction had comparable outcomes. Both techniques are associated with similar incidence of biliary stricture. The bilioenteric reconstruction was associated with a higher risk of cholangitis. The incidence of de novo cholangiocarcinoma was similar in both groups. Duct-to-duct reconstruction should be considered when feasible in patients with PSC.

Publication metadata

Author(s): Pandanaboyana S, Bell R, Bartlett AJ, McCall J, Hidalgo E

Publication type: Article

Publication status: Published

Journal: Transplant International

Year: 2015

Volume: 28

Issue: 4

Pages: 485-491

Print publication date: 04/03/2015

Online publication date: 03/01/2015

Acceptance date: 24/12/2014

ISSN (print): 0934-0874

ISSN (electronic): 1432-2277

Publisher: Blackwell Publishing Ltd


DOI: 10.1111/tri.12513

PubMed id: 25557556


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