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Comparison of efficacy and complications of endoscopic and percutaneous biliary drainage in malignant obstructive jaundice: a systematic review and meta-analysis.
Cancer Imaging. 2017 Oct 16; 17(1):27.CI

Abstract

BACKGROUND

Malignant obstructive jaundice is a common problem in the clinic. Currently, the generally applied treatment methods are percutaneous transhepatic biliary drainage (PTBD) and endoscopic biliary drainage (EBD). Nevertheless, there has not been a uniform conclusion published on either efficacy of the two types of drainage or the incidence rate of complications. Therefore, we conducted a systematic review and meta-analysis of studies comparing endoscopic versus percutaneous biliary drainage in malignant obstructive jaundice, to determine whether there is any difference between percutaneous and endoscopic biliary drainage, with respect to efficacy and incidence rate of overall complications.

METHODS

The enrolled studies contain a total of three randomized controlled trials and eleven retrospective studies, which together encompass 2246 patients with PTBD and 8100 patients with EBD.

RESULTS

Our analysis indicates that there is no difference between PTBD and EBD with regard to therapeutic success rate (%), overall complication (%), intraperitoneal bile leak, 30-day mortality, sepsis, or duodenal perforation (%). Cholangitis and pancreatitis after PTBD were lower than after EBD, with odds ratios (OR) of 0.48 (95% confidence interval (CI), 0.31 to 0.74) and 0.16 (95% CI, 0.05 to 0.52), respectively. Incidences of bleeding and tube dislocation for PTBD were higher than EBD, OR of 1.81 (95% CI, 1.35 to 2.44) and 3.41 (95% CI, 1.10 to 10.60).

CONCLUSIONS

This meta-analysis indicates certain advantages for both PTBD and EBD. In the clinical practice, it is advised to choose specifically either PTBD or EBD, based on location of obstruction, purpose of drainage (as a preoperative procedure or a palliative treatment) and level of experience in biliary drainage at individual treatment centers.

Authors+Show Affiliations

Department of Interventional Radiology, the General Hospital of Chinese People's Liberation Army, Beijing, 100853, China. duanfeng@vip.sina.com.Department of Interventional Radiology, the General Hospital of Chinese People's Liberation Army, Beijing, 100853, China.Department of Interventional Radiology, the General Hospital of Chinese People's Liberation Army, Beijing, 100853, China.Department of Interventional Radiology, the General Hospital of Chinese People's Liberation Army, Beijing, 100853, China.Department of Interventional Radiology, the General Hospital of Chinese People's Liberation Army, Beijing, 100853, China.Department of Interventional Radiology, the General Hospital of Chinese People's Liberation Army, Beijing, 100853, China.

Pub Type(s)

Comparative Study
Journal Article
Meta-Analysis
Review
Systematic Review

Language

eng

PubMed ID

29037223

Citation

Duan, Feng, et al. "Comparison of Efficacy and Complications of Endoscopic and Percutaneous Biliary Drainage in Malignant Obstructive Jaundice: a Systematic Review and Meta-analysis." Cancer Imaging : the Official Publication of the International Cancer Imaging Society, vol. 17, no. 1, 2017, p. 27.
Duan F, Cui L, Bai Y, et al. Comparison of efficacy and complications of endoscopic and percutaneous biliary drainage in malignant obstructive jaundice: a systematic review and meta-analysis. Cancer Imaging. 2017;17(1):27.
Duan, F., Cui, L., Bai, Y., Li, X., Yan, J., & Liu, X. (2017). Comparison of efficacy and complications of endoscopic and percutaneous biliary drainage in malignant obstructive jaundice: a systematic review and meta-analysis. Cancer Imaging : the Official Publication of the International Cancer Imaging Society, 17(1), 27. https://doi.org/10.1186/s40644-017-0129-1
Duan F, et al. Comparison of Efficacy and Complications of Endoscopic and Percutaneous Biliary Drainage in Malignant Obstructive Jaundice: a Systematic Review and Meta-analysis. Cancer Imaging. 2017 Oct 16;17(1):27. PubMed PMID: 29037223.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of efficacy and complications of endoscopic and percutaneous biliary drainage in malignant obstructive jaundice: a systematic review and meta-analysis. AU - Duan,Feng, AU - Cui,Li, AU - Bai,Yanhua, AU - Li,Xiaohui, AU - Yan,Jieyu, AU - Liu,Xuan, Y1 - 2017/10/16/ PY - 2017/07/27/received PY - 2017/10/06/accepted PY - 2017/10/18/entrez PY - 2017/10/19/pubmed PY - 2018/4/5/medline KW - Endoscopic biliary drainage KW - Malignant obstructive jaundice KW - Percutaneous biliary drainage SP - 27 EP - 27 JF - Cancer imaging : the official publication of the International Cancer Imaging Society JO - Cancer Imaging VL - 17 IS - 1 N2 - BACKGROUND: Malignant obstructive jaundice is a common problem in the clinic. Currently, the generally applied treatment methods are percutaneous transhepatic biliary drainage (PTBD) and endoscopic biliary drainage (EBD). Nevertheless, there has not been a uniform conclusion published on either efficacy of the two types of drainage or the incidence rate of complications. Therefore, we conducted a systematic review and meta-analysis of studies comparing endoscopic versus percutaneous biliary drainage in malignant obstructive jaundice, to determine whether there is any difference between percutaneous and endoscopic biliary drainage, with respect to efficacy and incidence rate of overall complications. METHODS: The enrolled studies contain a total of three randomized controlled trials and eleven retrospective studies, which together encompass 2246 patients with PTBD and 8100 patients with EBD. RESULTS: Our analysis indicates that there is no difference between PTBD and EBD with regard to therapeutic success rate (%), overall complication (%), intraperitoneal bile leak, 30-day mortality, sepsis, or duodenal perforation (%). Cholangitis and pancreatitis after PTBD were lower than after EBD, with odds ratios (OR) of 0.48 (95% confidence interval (CI), 0.31 to 0.74) and 0.16 (95% CI, 0.05 to 0.52), respectively. Incidences of bleeding and tube dislocation for PTBD were higher than EBD, OR of 1.81 (95% CI, 1.35 to 2.44) and 3.41 (95% CI, 1.10 to 10.60). CONCLUSIONS: This meta-analysis indicates certain advantages for both PTBD and EBD. In the clinical practice, it is advised to choose specifically either PTBD or EBD, based on location of obstruction, purpose of drainage (as a preoperative procedure or a palliative treatment) and level of experience in biliary drainage at individual treatment centers. SN - 1470-7330 UR - https://www.unboundmedicine.com/medline/citation/29037223/Comparison_of_efficacy_and_complications_of_endoscopic_and_percutaneous_biliary_drainage_in_malignant_obstructive_jaundice:_a_systematic_review_and_meta_analysis_ L2 - https://cancerimagingjournal.biomedcentral.com/articles/10.1186/s40644-017-0129-1 DB - PRIME DP - Unbound Medicine ER -