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Ali Raza,Anam Omer,Sara Iqbal,Vineet Gudsoorkar,Pramoda Koduru,Kumar Krishnan 대한소화기내시경학회 2019 Clinical Endoscopy Vol.52 No.2
Background/Aims: Bile leak is one of the most common complications of liver transplantation. The treatment options for bile leaksinclude conservative management, surgical re-intervention, percutaneous drainage and endoscopic drainage. We aimed to perform asystematic review to identify the effcacy 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 andrelevant 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 effcacy of biliary stents for the resolution of post-transplantbile leaks was 82.43% compared with 87.15% effcacy of nasobiliary tubes. The effcacy 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 effcacy of nasobiliary tubewas also lower for anastomotic leaks (58.33%) compared to T-tube or cut-surface related leaks (100%). Conclusions: In this systematic review, the overall effcacy 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.
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