Is percutaneous drainage better than endoscopic drainage in the management of patients with malignant obstructive jaundice? A meta-analysis of RCTs

被引:2
|
作者
Bian, Cnogwen [1 ,2 ]
Fang, Yuan [1 ]
Xia, Jun [3 ]
Shi, Lan [4 ]
Huang, Hanfei [1 ]
Xiong, Qiru [5 ]
Wu, Ruolin [6 ]
Zeng, Zhong [1 ]
机构
[1] Kunming Med Univ, Dept Gen Surg, Affiliated Hosp 1, Kunming, Peoples R China
[2] Univ Hong Kong, Li Ka Shing Fac Med, Dept Surg, Hong Kong, Peoples R China
[3] Anhui Med Univ, Dept Gen Surg, Affiliated Hosp 1, Hefei, Peoples R China
[4] Zhejiang Chinese Med Univ, Dept Clin Med Coll 4, Hangzhou, Zhejiang, Peoples R China
[5] Anhui Med Univ, Dept Gen Surg, Affiliated Hosp 2, Hefei, Peoples R China
[6] Anhui Med Univ, Organ Transplantat Ctr, Dept Hepatopancreatobiliary Surg, Dept Gen Surg,Affiliated Hosp 1, Hefei, Peoples R China
来源
FRONTIERS IN ONCOLOGY | 2023年 / 13卷
基金
中国国家自然科学基金;
关键词
ERCP; PTCD; Malignant obstructive jaundice; Procedure-related complication; Meta-analysis; PREOPERATIVE BILIARY DRAINAGE; RANDOMIZED-TRIAL; RISK-FACTORS;
D O I
10.3389/fonc.2023.1105728
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
To compare the safety and efficacy of endoscopic retrograde cholangiopancreatography (ERCP) and percutaneous transhepatic cholangial drainage (PTCD) in the treatment of malignant obstructive jaundice, a systematic review and meta-analysis of published studies was undertaken to assess the differences between the two procedures in terms of efficacy and safety. From November 2000 to November 2022, the Embase, PubMed, MEDLINE, and Cochrane databases were searched for randomized controlled trials (RCTs) on the treatment of malignant obstructive jaundice with ERCP or PTCD. Two investigators independently assessed the quality of the included studies and extracted the data. Six RCTs, including 407 patients, were included. The results of the meta-analysis showed that the overall technical success rate in the ERCP group was significantly lower than that in the PTCD group (Z=3.19, P=0.001, OR=0.31 (95% CI: 0.15-0.64)), but with a higher overall procedure-related complication incidence rate (Z=2.57, P=0.01, OR=0.55 (95% CI: 0.34-0.87)). The incidence of procedure-related pancreatitis in the ERCP group was higher than that in the PTCD group (Z=2.80, P=0.005, OR=5.29 (95% CI: 1.65-16.97)), and the differences were statistically significant. No significant difference was observed between the two groups when the clinical efficacy, postoperative cholangitis, and bleeding rate were compared.Both treatments for malignant obstructive jaundice were efficacious and safe. However, the PTCD group had a greater technique success rate and a lower incidence of postoperative pancreatitis.The present meta-analysis has been registered in PROSPERO
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页数:8
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