title: Value of T-tube in biliary tract reconstruction during orthotopic liver transplantation: a meta-analysis.
abstract: OBJECTIVE
  To compare biliary complications after biliary tract reconstruction with or without T-tube in orthotopic liver transplantation.
  
  
  METHODS
  Randomized control trials (RCTs) and comparative studies were identified by a computerized literature search of the Cochrane Library, MEDLINE (1966/1-2010/4), Scopus (1980/1-2010/4), ClinicalTrials.gov (2010/4), the Cochrane Hepato-Biliary Group Controlled Trials Register, and the Cochrane Central Register of Controlled Trials. Studies and data were extracted and assessed independently. Dichotomous outcomes were reported as odds ratios (ORs) and weighted mean difference with 95% confidence intervals (CI).
  
  
  RESULTS
  Five RCTs and eight comparative studies with a total of 1 608 subjects were identified. The data showed that the operation with T-tube had better outcomes for duct stenosis (P=0.01, OR=0.45, 95% CI 0.24-0.85). The operations with or without T-tube had equivalent outcomes as follows: overall biliary complications (P=0.85, OR=1.15, 95% CI 0.28-4.72), bile leaks (P=0.38, OR=0.75, 95% CI 0.39-1.42), and cholangitis (P=0.24, OR=4.64, 95% CI 0.36-60.62). These results were strengthened by the analysis of all thirteen non-randomized and randomized studies.
  
  
  CONCLUSIONS
  Our systematic review and meta-analysis suggest that the insertion of a T-tube reduces the incidence of biliary stenosis without increasing the incidence of other biliary complications.
authors.affiliation: Department of Emergency, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
authors.forename: Wei-dong
authors.initials: WD
authors.lastname: Huang
authors.forename: Jiu-kun
authors.initials: JK
authors.lastname: Jiang
authors.forename: Yuan-qiang
authors.initials: YQ
authors.lastname: Lu
mesh_terms: D000714:Anastomosis, Surgical / Q000009:adverse effects; D001662:Biliary Tract Surgical Procedures / Q000009:adverse effects / Q000295:instrumentation*; D002761:Cholangitis / Q000517:prevention & control; D003251:Constriction, Pathologic; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects / Q000379:methods*; D016017:Odds Ratio; D011183:Postoperative Complications / Q000517:prevention & control; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome