Published online Apr 14, 2021. doi: 10.3748/wjg.v27.i14.1507
Peer-review started: December 3, 2020
First decision: December 21, 2020
Revised: December 29, 2020
Accepted: March 18, 2021
Article in press: March 18, 2021
Published online: April 14, 2021
The use of the T-tube in the reconstruction of the biliary tree during orthotopic liver transplantation (OLT) is still debatable.
Biliary complications after OLT, including bile leaks, cholangitis, and biliary strictures, prolonged the hospital stay, impaired the postoperative recovery, and increased the medical costs. T-tube was involved in the occurrence of these biliary complications. Therefore, it is helpful to identify the role of T-tube in the incidence of the biliary complications.
We performed a meta-analysis to evaluate whether patients benefit from the use of a T-tube during OLT.
We calculated odds ratios with 95% confidence intervals to identify the role of a T-tube in the incidence of the overall biliary complications, bile leaks, cholangitis, and biliary strictures.
We discovered that T-tube had no influence on the risk of the overall biliary complications, bile leaks, and cholangitis and reduced the incidence of biliary strictures in the period from 1995 to 2010. However, in the recent decade (from 2010 to 2020), we found that T-tube did not affect the occurrence of biliary strictures and increased the incidence of overall biliary complications and cholangitis. And the use of a T-tube showed an unbeneficial trend for bile leak after 2010.
In conclusion, the evidence gathered in our updated meta-analysis showed that the studies published in the last decade did not provide enough evidence to support the routine use of T-tube in adults during OLT.
More T-tube-related outcomes should be included in the future meta-analysis so the advantages and disadvantages would be evaluated better.