The impact and the risk factors of different preoperative biliary drainage procedures for patients with malignant obstruction jaundice on overall survival : a Meta-analysis
10.3760/cma.j.issn.1007-8118.2018.12.008
- VernacularTitle:术前不同胆管引流方式对恶性梗阻性黄疸患者总生存率的影响及其Meta分析
- Author:
Lei WANG
1
;
Nanping LIN
;
Qiao KE
;
Zhiqiang LIU
;
Yongyi ZENG
;
Jingfeng LIU
Author Information
1. 350025,福建医科大学孟超肝胆医院福建省肝病科学研究中心福建省联合创新重点实验室
- Keywords:
Malignant obstruction jaundice;
Preoperative biliary drainage;
Percutaneous transhepatic biliary drainage;
Endoscopic biliary drainage;
Overall survival;
Meta-analysis
- From:
Chinese Journal of Hepatobiliary Surgery
2018;24(12):823-828
- CountryChina
- Language:Chinese
-
Abstract:
Objective To determine the impact and the risk factors of different methods of preoperative biliary drainage (PBD) for malignant obstruction jaundice (MOJ) on overall survival (OS).Methods Databases including the PubMed,Medline,Web of Knowledge,and other databases were searched up to 30th April,2018 for clinical studies which compared the OS rates between percutaneous transhepatic biliary drainage (PTBD) and endoscopic biliary drainage (EBD) for MOJ.Hazard ratio (HR) and Odds Ratio (OR) with 95％ confidence interval (CI) were performed using the Review Manager 5.3 software to synthesize the results.Results Nine studies were enrolled in this meta-analysis,which included 818 patients in the PTBD group and 1253 patients in the EBD group.EBD was shown to be superior to PTBD in OS (HR=0.63,95％ CI:0.51～0.77,P＜0.05).Risk factors analysis showed that patients in the EBD group had a higher rate of early tumor stage (P＜0.05) and a lower rate of lymphatic metastasis (P＜0.05).When compared with the PTBD group,the EBD group had a lower rate of intraoperative bleeding (P＜0.05),and a higher rate of adjuvant therapy (P＜0.05).Conclusion In PBD for patients with resectable MOJ,there was insufficient evidence to support EBD to be superior to PTBD in OS.
