Lishuang Ma, Zhen Chen, Guoliang Qiao, Zhen Zhang, Chen Wang, Long Li, Shuli Liu
Department of Pediatric Surgery, Capital Institute of Pediatrics, Teaching hospital of Peking University, Yabao Road2#, Chaoyang, Beijing, 100021, People's Republic of China.
Pediatr Surg Int. 2015 Mar;31(3):261-9. doi: 10.1007/s00383-015-3662-7. Epub 2015 Jan 28.
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.
Systematic review and meta-analysis.
Medline, Ovid, Elsevier, Google Scholar Embase, Cohrane library.
Comparative cohort studies.
Two investigators independently assessed selected studies and extracted the following information: study characteristics, quality, outcomes data, etc.
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.
Laparoscopic portoenterostomy could not replace open portoenterostomy and open Kasai portoenterostomy remains the gold standard in the treatment of biliary atresia.
开放性肝门空肠吻合术（OPE）仍是治疗胆道闭锁的主要方法，而在过去几年中，腹腔镜肝门空肠吻合术（LPE）已被广泛应用。然而，LPE的安全性仍是一个主要问题。因此，我们进行了一项系统评价和荟萃分析，以回顾目前比较LPE和OPE的可用数据。
系统评价和荟萃分析。
医学期刊数据库（Medline）、Ovid、爱思唯尔（Elsevier）、谷歌学术、Embase、考克兰图书馆（Cohrane library）。
比较队列研究。
两名研究人员独立评估所选研究，并提取以下信息：研究特征、质量、结果数据等。
通过荟萃分析对11项关于LPE与OPE有效性的研究进行了分析。荟萃分析发现，两组在手术时间、住院时间、术中出血量、黄疸早期清除率、胆管炎和静脉曲张出血方面无显著差异。此外，OPE组的自体肝2年生存率显著高于LPE组。
腹腔镜肝门空肠吻合术不能替代开放性肝门空肠吻合术，开放性Kasai肝门空肠吻合术仍是治疗胆道闭锁的金标准。
