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SYSTEMATIC REVIEW article

Front. Pediatr.
Sec. Pediatric Surgery
Volume 12 - 2024 | doi: 10.3389/fped.2024.1476195

Laparoscopic vs. Open Portoenterostomy for Biliary Atresia: A Meta-Analysis of Pediatric Surgical Outcomes

Provisionally accepted
Jie Zhu Jie Zhu Bin Wu Bin Wu Peng Cai Peng Cai Jiang Pan Jiang Pan Zhenwei Zhu Zhenwei Zhu *
  • Children's Hospital of Soochow University, Suzhou, China

The final, formatted version of the article will be published soon.

    Background: The pivotal importance of surgical treatment for pediatric biliary atresia is well-established. This systematic review and meta-analysis was designed to assess the comparative efficacy and safety of open portoenterostomy (OPE) and laparoscopic portoenterostomy (LPE) in managing this condition, providing valuable guidance for clinical decision-making. Methods: A comprehensive literature review was conducted by two researchers in databases such as PubMed, up to July 10, 2024, focusing on studies that evaluated the role of LPE versus OPE. Data analysis was performed utilizing the RevMan 5.4 software suite. Results: The meta-analysis incorporated findings from 15 studies involving a total of 964 pediatric patients with biliary atresia. LPE was associated with decreased intraoperative blood loss [Mean Difference (MD) = -10.80, 95% Confidence Interval (CI) (-13.54, -8.05)] and shortened hospital stay [MD = -2.18, 95% CI (-3.69, -0.67)]. Conversely, the operative time for LPE was considerably longer when compared to OPE [MD = 35.45, 95% CI (26.17, 44.72)]. No significant disparities were noted in the postoperative jaundice clearance rate [Odds Ratio (OR) = 0.98, 95% CI (0.71, 1.35)], incidence of postoperative cholangitis [OR = 0.96, 95% CI (0.66, 1.39)], the rate of liver transplantation between the two surgical approaches [OR = 0.69, 95% CI (0.32, 1.48)], or 2-year survival of the native liver [OR = 1.10, 95% CI (0.67, 1.80)]. Conclusion: LPE offers more advantages over OPE, including diminished invasiveness and expedited recovery. These benefits suggest that LPE is an emerging and viable alternative in the clinical management of biliary atresia, warranting further investigation and consideration in surgical practice.

    Keywords: Biliary Atresia, Portoenterostomy, Laparoscopy, Children, Surgery, Treatment

    Received: 05 Aug 2024; Accepted: 18 Nov 2024.

    Copyright: © 2024 Zhu, Wu, Cai, Pan and Zhu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Zhenwei Zhu, Children's Hospital of Soochow University, Suzhou, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.