Laparoscopic portoenterostomy versus open portoenterostomy for the treatment of biliary atresia: a systematic review and meta-analysis of comparative studies.

BACKGROUND

Open portoenterostomy (OPE) remains the mainstay in treatment of biliary atresia, while during the past several years, the laparoscopic portoenterostomy (LPE) has been widely introduced. However, safety of LPE remains a major concern. Thus, we conducted a systematic review and meta-analysis to review the currently available data comparing LPE and OPE.

DESIGN

Systematic review and meta-analysis.

DATA SOURCES

Medline, Ovid, Elsevier, Google Scholar Embase, Cohrane library.

STUDY SELECTION

Comparative cohort studies.

DATA EXTRACTION

Two investigators independently assessed selected studies and extracted the following information: study characteristics, quality, outcomes data, etc.

RESULTS

Eleven studies about the effectiveness of LPE compared with OPE were performed by meta-analysis. Meta-analysis found no significant difference between the two groups in operative time, hospital stay, intraoperative blood loss, early clearance of jaundice, cholangitis and variceal bleeding. In addition, the rate of 2-year survival with native liver was significantly high in OPE group than in LPE group.

CONCLUSION

Laparoscopic portoenterostomy could not replace open portoenterostomy and open Kasai portoenterostomy remains the gold standard in the treatment of biliary atresia.