2.Photodynamic therapy plus biliary stenting versus biliary stenting alone to treat nonresectable ductal cholangiocarcinoma: a Meta-analysis
Shiming CHEN ; Yue LOU ; Xuan FANG ; Gentu XU ; Jianyao CHEN
Chinese Journal of Hepatobiliary Surgery 2018;24(9):616-621
Objective To compare the therapeutic results of photodynamic therapy (PDT) combined with biliary stenting versus biliary stenting alone in the treatment of nonresectable bile duct cholangiocarcinoma.Methods The PubMed,CBM,CNKI,VIP and WanFang Data were searched from January 1990 to December 2017.Two researchers independently screened the literatures,extracted the data and performed the quality evaluation.The meta-analysis was carried out using the RevMan software 5.3.0.Results Eleven controlled clinical trials were included in the meta-analysis.There were only two randomized controlled trials.The remaining studies were non-randomized controlled trials.Finally,659 patients were enrolled in this study.293 patients were treated with photodynamic therapy and biliary stenting while 366 patients were treated with stenting alone.Analysis showed that photodynamic therapy combined with stenting significantly extended the overall survival when compared with stenting alone (P<0.01).There was no significant differences in the incidences of cholangitis (P>0.05),but PDT and stenting had a significantly higher total complication rate (P<0.05).Conclusions This meta-analysis showed that photodynamic therapy combined with stenting significantly improved the survival rate of patients with nonresectable ductal cholangiocarcinoma when compared with stenting alone.Photodynamic therapy did not increase the incidence of cholangitis.