The role of graft reperfusion sequence in the development of non-anastomotic biliary strictures following orthotopic liver transplantation: A meta-analysis.Bekheit, M., Catanzano, M. et al.
Hepatobiliary & Pancreatic Diseases International, 2018; 18(1):4-11
This study aimed to compare the incidence of non-anastomotic biliary stricture and other surgical complications in initial portal reperfusion (sequential) compared to simultaneous or initial artery reperfusion.
Meta-analysis of published studies comparing outcomes in initial portal reperfusion versus simultaneous artery reperfusion. Studies were identified under the guidance of the Cochrane guidelines for systematic reviews and meta-analysis.
Analysis included 7 studies and 685 patients.
The primary outcomes of this study included prevalence of non-anastomotic biliary strictures and reperfusion injury or damage to the transplanted liver. Secondary outcomes included, hospital stay, operative time and cold ischemia.
Up to 18 months
This systematic review searched a wide variety of databases and used specific search strategies for each, and data extraction was done in duplicate. There were only 7 studies included, and these were a mixture of RCTs and other comparative study types. The authors found no evidence for a difference in non-anastomotic biliary strictures when comparing different strategies for hepatic allograft reperfusion. The most significant weakness is the lack of information on the delay time between portal and arterial reperfusion in the delayed group.