Evidence map›Paper›PMID 39592482›Full record

SynthesisPediatric surgery international2024

Comparison of different Kasai portoenterostomy techniques in the outcomes of biliary atresia: a systematic review and network meta-analysis.

Yanran Zhang, Shaowen Liu, Qianhui Yang, Rongjuan Sun, Jiaying Liu, Yu Meng, Jianghua Zhan

Abstract readSystematic ReviewComparative StudyNetwork Meta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Pediatric surgery international, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Yanran Zhang *Clinical School of Paediatrics, Tianjin Medical University, Tianjin, 300400, China.
Shaowen Liu *Clinical School of Paediatrics, Tianjin Medical University, Tianjin, 300400, China.
Qianhui Yang *Clinical School of Paediatrics, Tianjin Medical University, Tianjin, 300400, China.
Rongjuan SunClinical School of Paediatrics, Tianjin Medical University, Tianjin, 300400, China.
Jiaying LiuClinical School of Paediatrics, Tianjin Medical University, Tianjin, 300400, China.
Yu MengClinical School of Paediatrics, Tianjin Medical University, Tianjin, 300400, China.
Jianghua ZhanDepartment of General Surgery, Tianjin Children's Hospital, Tianjin, 300134, China. zhanjianghuatj@163.com.

Funding

Tianjin Applied Basic Research Project No.22JCZDJC00290Tianjin Key Medical Discipline (Specialty) Construction Project TJYXZDXK-040A
6 · The paper itself

Abstract

backgroundBiliary atresia (BA) is a progressive disease affecting the bile duct structure and function, leading to poor outcomes without timely surgical intervention. Kasai portoenterostomy (KPE) is a commonly used treatment to restore bile flow. However, the success rate and postoperative outcomes of KPE vary with different surgical techniques, including laparoscopic, robot-assisted, and open approaches.

methodsFollowing the PRISMA guidelines, this study systematically searched PubMed, EMBASE, and Cochrane databases for literature on BA surgical techniques of KPE. Studies comparing two or all three techniques-laparoscopic, robot-assisted, and open-in terms of postoperative outcomes of KPE in BA patients were included. Utilizing the "gemtc" package in R version 4.3.3, NMA was conducted to compare postoperative clearance of jaundice (COJ) among different surgical techniques. We also performed traditional paired meta-analysis in which multiple surgical outcomes were compared.

resultsAccording to the traditional definition of a successful KPE surgery, in terms of successful postoperative COJ, robotic-assisted Kasai portoenterostomy (RAKPE) shows advantage over open Kasai portoenterostomy (OKPE) and laparoscopic Kasai portoenterostomy (LKPE), while the outcomes between OKPE and LKPE are equivalent. However, statistically speaking, there is no significant difference among the three techniques. LKPE has a longer operation time and less intraoperative bleeding compared to OKPE. There are no statistically significant differences in hospital stay, cholangitis incidence, or liver survival rates at 6 months, 1 year, 2 years, or 5 years.

conclusionThe surgical success rates of KPE with various technical aids are similar, highlighting the need to consider individual patient conditions and cost when choosing a surgical technique. Effective postoperative management is vital for preventing complications and slowing liver fibrosis. Future research should focus on improving surgical techniques and postoperative care to enhance long-term outcomes for BA patients. For those who cannot maintain liver function with KPE, timely LT consideration is crucial.

Indexed as

Biliary AtresiaPortoenterostomy, HepaticHumansLaparoscopyPostoperative ComplicationsRobotic Surgical ProceduresTreatment OutcomeBiliary atresiaKasai portoenterostomyLaparoscopic Kasai portoenterostomy (LKPE)Network meta-analysisRobotic-assisted Kasai portoenterostomy (RAKPE)

Identifiers

PMID39592482

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.