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Laparoscopic versus open portoenterostomy for treatment of biliary atresia: a meta-analysis

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Abstract

Objective

Our goal was to compare laparoscopic portoenterostomy versus open portoenterostomy for the treatment of biliary atresia.

Materials and methods

Using the databases EMBASE, PubMed, and Cochrane, we carried out a thorough literature search up to 2022. Studies comparing laparoscopic and open surgery for the treatment of biliary atresia were included.

Results

Twenty-three studies comparing laparoscopic portoenterostomy (LPE) (n = 689) and open portoenterostomy (OPE) (n = 818) were considered appropriate for meta-analysis. Age at surgery time was lower in the LPE group than OPE group (I2 = 84%), (WMD − 4.70, 95% CI − 9.14 to − 0.26; P = 0.04). Significantly decreased blood loss (I2 = 94%), (WMD − 17.85, 95% CI − 23.67 to − 12.02; P < 0.00001) and time to feed were found in the laparoscopic group (I2 = 97%), (WMD − 2.88, 95% CI − 4.71 to − 1.04; P = 0.002). Significantly decreased operative time was found in the open group (I2 = 85%), (WMD 32.52, 95% CI 15.65–49.39; P = 0.0002). Weight, transfusion rate, overall complication rate, cholangitis, time to drain removal, length of stay, jaundice clearance, and two-year transplant-free survival were not significantly different across the groups.

Conclusions

Laparoscopic portoenterostomy provides advantages regarding operative bleeding and the time to begin feeding. No differences in remain characteristics. Based on the data presented to us by this meta-analysis, LPE is not superior to OPE in terms of overall results.

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Authors and Affiliations

  1. Faculty of Medicine, Department of Pediatric Surgery, Dicle University, Diyarbakır, Turkey

    Mehmet Hanifi Okur, Bahattin Aydoğdu & Mustafa Azizoğlu

  2. Faculty of Medicine, Department of Pediatric Surgery, Mardin Artuklu University, Mardin, Turkey

    Salim Bilici & Salih Bayram

  3. Faculty of Medicine, Department of Anesthesiology and Reanimation, Dicle University, Diyarbakır, Turkey

    Fikret Salik

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  1. Mehmet Hanifi Okur
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  2. Bahattin Aydoğdu
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  3. Mustafa Azizoğlu
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  4. Salim Bilici
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  5. Salih Bayram
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Contributions

Research concept and design: MA, MHO, BA, SBil, SB Data analysis and interpretation: FS, MA, BA, MHO, SBil Collection and/or assembly of data: FS, MA, BA, MHO Writing the article: FS, SBil, SB Critical revision of the article: MA, MHO, SB Final approval of the article: MHO, MA.

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Correspondence to Mustafa Azizoğlu.

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Okur, M.H., Aydoğdu, B., Azizoğlu, M. et al. Laparoscopic versus open portoenterostomy for treatment of biliary atresia: a meta-analysis. Pediatr Surg Int 39, 148 (2023). https://doi.org/10.1007/s00383-023-05436-8

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