Giri Suprabhat, Sahu Saroj K, Mohapatra Vedavyas, Chaudhary Mansi, Panigrahi Manas, Nath Preetam, Mallick Bipadabhanjan, Praharaj Dibya L
Gastroenterology and Hepatology, Kalinga Institute of Medical Sciences, Bhubaneswar, IND.
Surgical Gastroenterology, Kalinga Institute of Medical Sciences, Bhubaneswar, IND.
Cureus. 2024 Sep 9;16(9):e69019. doi: 10.7759/cureus.69019. eCollection 2024 Sep.
To understand if the risk of biliary complications is higher with living donor liver transplantation (LDLT) compared to deceased donor liver transplantation (DDLT), the present meta-analysis was conducted to analyze the differences between these two types of liver transplantations. Three databases were searched from inception to September 2023 for comparative studies reporting biliary complications with LDLT and DDLT. Odds ratios (OR) with 95% confidence intervals were calculated for all the dichotomous outcomes. Twenty-eight studies were included in the final analysis. LDLT was associated with a significantly higher incidence of biliary complications than DDLT (OR 1.96, 95% CI: 1.56-2.47). However, on subgroup analysis, only studies published in or before 2014 reported a higher incidence of biliary complications with LDLT, but not with studies published after 2014. An analysis of individual adverse events showed that LDLT was associated with a higher incidence of both bile leak (OR 3.38, 95% CI: 2.52-4.53) and biliary stricture (OR 1.75, 95% CI: 1.20-2.55). LDLT was associated with a higher incidence of overall biliary complications, including bile leak and biliary stricture. With advances in surgical techniques, there has been a reduction in the risk of biliary complications.
为了解活体供肝肝移植（LDLT）与尸体供肝肝移植（DDLT）相比，胆道并发症的风险是否更高，本荟萃分析旨在分析这两种肝移植类型之间的差异。检索了三个数据库，从建库至2023年9月，查找报告LDLT和DDLT胆道并发症的比较研究。对所有二分结局计算比值比（OR）及95%置信区间。最终分析纳入了28项研究。LDLT的胆道并发症发生率显著高于DDLT（OR 1.96，95% CI：1.56 - 2.47）。然而，亚组分析显示，只有2014年及以前发表的研究报告LDLT的胆道并发症发生率较高，2014年以后发表的研究则未发现此现象。对个体不良事件的分析表明，LDLT与胆漏（OR 3.38，95% CI：2.52 - 4.53）和胆道狭窄（OR 1.75，95% CI：1.20 - 2.55）的发生率较高相关。LDLT与包括胆漏和胆道狭窄在内的总体胆道并发症发生率较高相关。随着手术技术的进步，胆道并发症的风险有所降低。
