Efficacy of Nasobiliary Tubes and Biliary Stents in Management of Patients with Bile Leak after Liver Transplantation: A Systematic Review
Background/Aims Bile leak is one of the most common complications of liver transplantation. The treatment options for bile leaks include conservative management, surgical re-intervention, percutaneous drainage and endoscopic drainage. We aimed to perform a systematic review to identify the efficacy...
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| Format: | Article |
| Language: | English |
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Korean Society of Gastrointestinal Endoscopy
2019-03-01
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| Series: | Clinical Endoscopy |
| Subjects: | |
| Online Access: | http://www.e-ce.org/upload/pdf/ce-2018-118.pdf |
| _version_ | 1797421321427091456 |
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| author | Ali Raza Anam Omer Sara Iqbal Vineet Gudsoorkar Pramoda Koduru Kumar Krishnan |
| author_facet | Ali Raza Anam Omer Sara Iqbal Vineet Gudsoorkar Pramoda Koduru Kumar Krishnan |
| author_sort | Ali Raza |
| collection | DOAJ |
| description | Background/Aims Bile leak is one of the most common complications of liver transplantation. The treatment options for bile leaks include conservative management, surgical re-intervention, percutaneous drainage and endoscopic drainage. We aimed to perform a systematic review to identify the efficacy of endoscopic treatment in the resolution of post-transplant bile leaks. Methods Two independent reviewers performed systematic literature search in PubMed, ISI Web of Science, grey literature and relevant references in May 2017. Human studies in English with documented post-liver transplant bile leaks were included. Results Thirty-four studies were included in the final analysis. The pooled efficacy of biliary stents for the resolution of post-transplant bile leaks was 82.43% compared with 87.15% efficacy of nasobiliary tubes. The efficacy of biliary stents was lower for anastomotic leaks (69.23%) compared to T-tube (90.9%) or cut-surface/ cystic duct stump related leaks (92.8%). Similarly, the efficacy of nasobiliary tube was also lower for anastomotic leaks (58.33%) compared to T-tube or cut-surface related leaks (100%). Conclusions In this systematic review, the overall efficacy was 82.43% in biliary stent group, and 87.15% in nasobiliary tube group. Both biliary stent and nasobiliary tube were more effective in managing non-anastomotic leaks compared to anastomotic leaks. |
| first_indexed | 2024-03-09T07:15:12Z |
| format | Article |
| id | doaj.art-59e645881ec249a98412eabcaabbcb0d |
| institution | Directory Open Access Journal |
| issn | 2234-2400 2234-2443 |
| language | English |
| last_indexed | 2024-03-09T07:15:12Z |
| publishDate | 2019-03-01 |
| publisher | Korean Society of Gastrointestinal Endoscopy |
| record_format | Article |
| series | Clinical Endoscopy |
| spelling | doaj.art-59e645881ec249a98412eabcaabbcb0d2023-12-03T08:39:58ZengKorean Society of Gastrointestinal EndoscopyClinical Endoscopy2234-24002234-24432019-03-0152215916710.5946/ce.2018.1187210Efficacy of Nasobiliary Tubes and Biliary Stents in Management of Patients with Bile Leak after Liver Transplantation: A Systematic ReviewAli Raza0Anam Omer1Sara Iqbal2Vineet Gudsoorkar3Pramoda Koduru4Kumar Krishnan5 Division of Gastroenterology, Department of Medicine, Houston Methodist Hospital, Weill Cornell Medicine, Houston, TX, USA Department of Medicine, Houston Methodist Hospital, Weill Cornell Medicine, Houston, TX, USA Department of Medicine, Houston Methodist Hospital, Weill Cornell Medicine, Houston, TX, USA Division of Gastroenterology, Department of Medicine, Houston Methodist Hospital, Weill Cornell Medicine, Houston, TX, USA Division of Gastroenterology, Department of Medicine, Houston Methodist Hospital, Weill Cornell Medicine, Houston, TX, USA Division of Gastroenterology, Department of Medicine, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USABackground/Aims Bile leak is one of the most common complications of liver transplantation. The treatment options for bile leaks include conservative management, surgical re-intervention, percutaneous drainage and endoscopic drainage. We aimed to perform a systematic review to identify the efficacy of endoscopic treatment in the resolution of post-transplant bile leaks. Methods Two independent reviewers performed systematic literature search in PubMed, ISI Web of Science, grey literature and relevant references in May 2017. Human studies in English with documented post-liver transplant bile leaks were included. Results Thirty-four studies were included in the final analysis. The pooled efficacy of biliary stents for the resolution of post-transplant bile leaks was 82.43% compared with 87.15% efficacy of nasobiliary tubes. The efficacy of biliary stents was lower for anastomotic leaks (69.23%) compared to T-tube (90.9%) or cut-surface/ cystic duct stump related leaks (92.8%). Similarly, the efficacy of nasobiliary tube was also lower for anastomotic leaks (58.33%) compared to T-tube or cut-surface related leaks (100%). Conclusions In this systematic review, the overall efficacy was 82.43% in biliary stent group, and 87.15% in nasobiliary tube group. Both biliary stent and nasobiliary tube were more effective in managing non-anastomotic leaks compared to anastomotic leaks.http://www.e-ce.org/upload/pdf/ce-2018-118.pdfBiliary fistulaLiving donor liver transplantDeceased donor liver transplantNasobiliary tubeBiliary stent |
| spellingShingle | Ali Raza Anam Omer Sara Iqbal Vineet Gudsoorkar Pramoda Koduru Kumar Krishnan Efficacy of Nasobiliary Tubes and Biliary Stents in Management of Patients with Bile Leak after Liver Transplantation: A Systematic Review Clinical Endoscopy Biliary fistula Living donor liver transplant Deceased donor liver transplant Nasobiliary tube Biliary stent |
| title | Efficacy of Nasobiliary Tubes and Biliary Stents in Management of Patients with Bile Leak after Liver Transplantation: A Systematic Review |
| title_full | Efficacy of Nasobiliary Tubes and Biliary Stents in Management of Patients with Bile Leak after Liver Transplantation: A Systematic Review |
| title_fullStr | Efficacy of Nasobiliary Tubes and Biliary Stents in Management of Patients with Bile Leak after Liver Transplantation: A Systematic Review |
| title_full_unstemmed | Efficacy of Nasobiliary Tubes and Biliary Stents in Management of Patients with Bile Leak after Liver Transplantation: A Systematic Review |
| title_short | Efficacy of Nasobiliary Tubes and Biliary Stents in Management of Patients with Bile Leak after Liver Transplantation: A Systematic Review |
| title_sort | efficacy of nasobiliary tubes and biliary stents in management of patients with bile leak after liver transplantation a systematic review |
| topic | Biliary fistula Living donor liver transplant Deceased donor liver transplant Nasobiliary tube Biliary stent |
| url | http://www.e-ce.org/upload/pdf/ce-2018-118.pdf |
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