Biliary reconstruction after choledochal cyst resection: a systematic review and meta-analysis on hepaticojejunostomy vs hepaticoduodenostomy.

Autor: Hinojosa-Gonzalez DE; Tecnológico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Ave. Batallón San Patricio #112, San Pedro Garza García, Monterrey, Nuevo León, Mexico. dhigo.md@gmail.com., Roblesgil-Medrano A; Tecnológico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Ave. Batallón San Patricio #112, San Pedro Garza García, Monterrey, Nuevo León, Mexico., Leon SUV; Tecnológico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Ave. Batallón San Patricio #112, San Pedro Garza García, Monterrey, Nuevo León, Mexico., Espadas-Conde MA; Tecnológico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Ave. Batallón San Patricio #112, San Pedro Garza García, Monterrey, Nuevo León, Mexico., Flores-Villalba E; Tecnológico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Ave. Batallón San Patricio #112, San Pedro Garza García, Monterrey, Nuevo León, Mexico.; Tecnológico de Monterrey, Escuela de Ingeniería y Ciencias, Monterrey, Nuevo León, Mexico.; Laboratorio Nacional de Manufactura Aditiva y Digital (MADIT), Apodaca, Nuevo León, Mexico.
Jazyk: angličtina
Zdroj: Pediatric surgery international [Pediatr Surg Int] 2021 Oct; Vol. 37 (10), pp. 1313-1322. Date of Electronic Publication: 2021 Jun 11.
DOI: 10.1007/s00383-021-04940-z
Abstrakt: Choledochal cysts are a rare pediatric biliary pathology. Excision of the extrahepatic cyst and restoration of biliary-enteric continuity through either hepaticoduodenostomy (HD) or Roux-en-Y hepaticojejunostomy (HJ) is the mainstay treatment. This study aims to determine if either method provides an advantage. Following PRISMA guidelines, a systematic review was conducted, identifying studies comparing hepaticojejunostomy to hepaticoduodenostomy in patients with choledochal cysts. Data were analyzed using Review Manager 5.3. Nine studies were included, operative time was shorter - 97.50 [- 172.31, - 22.69] p = 0.01 and bleeding reduced - 48.98 [- 88.25, - 9.71] p = 0.01 in HD. HD was associated with shorter length of stay 2.18 [- 3.87, - 0.50] p = 0.01 and similar cholangitis and reintervention rates. Time to a normal diet was similar between groups. Biliary reflux was seen more frequently in HD 19.14 [2.60, 140.63] p = 0.004. Complications such as leak and cholangitis were similar between groups. HD represents a viable alternative to HJ with various advantages such as shorter operative time, decreased bleeding and shorter length of hospital stay. Bile reflux remains a major limitation.Level of evidence IV.
(© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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