Comparison of laparoscopic portoenterostomy and open portoenterostomy for the treatment of biliary atresia

  • Yanan Li
  • Jinran Gan
  • Chuan Wang
  • Zhicheng Xu
  • Yiyang Zhao
  • Yi JiEmail author
Review Article



Although open portoenterostomy (OPE) is considered the standard treatment for biliary atresia (BA), laparoscopic portoenterostomy (LPE) is conducted and reported by many investigators. Data on the safety and efficacy of LPE remain controversial. The aim of this meta-analysis is to compare the safety and efficacy of LPE and OPE for the treatment of BA.


Three electronic databases were searched: PubMed, Embase, and the Cochrane Library. The eligible studies were limited to those published in English. The following keywords were used: “biliary atresia,” “laparoscopic portoenterostomy,” “Kasai portoenterostomy,” “open portoenterostomy,” “surgery,” and “treatment.”


Nine studies, including 434 patients, were analyzed. The operative time of LPE was significantly longer than that of OPE (MD = 40.55 min, 95% CI 4.83–76.27 min, P = 0.03). There was no significant difference between the two groups in terms of the time of hospital stay, the volume of intraoperative blood loss, or the rates of cholangitis, early clearance of jaundice or two-year survival with the native liver. The subgroup analyses revealed that the rate of early clearance of jaundice in the LPE group was significantly higher than that in the OPE group in studies published after 2016 (95% CI 1.04–1.75; P = 0.02).


The present meta-analysis provides evidence that LPE is a feasible option for patients with BA. LPE should be revaluated by further studies and longer follow-up.


Pediatric Biliary atresia Laparoscopy Portoenterostomy 



This project was supported by grants from the National Natural Science Foundation of China (Grants 81401606 and 81400862), the Key Project in the Science & Technology Program of Sichuan Province (Grant 19ZDYF1454), and the Science Foundation for The Excellent Youth Scholars of Sichuan University (Grant 2015SU04A15).

Compliance with ethical standards


Yanan Li, Chuan Wang, Jinran Gan, Zhicheng Xu, Yiyang Zhao, and Yi Ji have no conflicts of interest or financial ties to disclose.


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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Division of Oncology, Department of Pediatric SurgeryWest China Hospital of Sichuan UniversityChengduChina
  2. 2.Department of Operations ManagementWest China Hospital of Sichuan UniversityChengduChina

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