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- Title
How to Choose Between Percutaneous Transhepatic and Endoscopic Biliary Drainage in Malignant Obstructive Jaundice: An Updated Systematic Review and Meta-analysis.
- Authors
RIZZO, ALESSANDRO; RICCI, ANGELA DALIA; FREGA, GIORGIO; PALLONI, ANDREA; DE LORENZO, STEFANIA; ABBATI, FRANCESCA; MOLLICA, VERONICA; TAVOLARI, S. IMONA; DI MARCO, MARIACRISTINA; BRANDI, GIOVANNI
- Abstract
Background/Aim: Malignant obstructive jaundice (MOJ) is a common condition caused by several primary and secondary cancers. We performed a systematic review and meta-analysis to investigate technical success rate and safety of percutaneous transhepatic biliary drainage (PTBD) versus endoscopic biliary drainage (EBD) in MOJ. Materials and Methods: Relevant trials were identified by searching electronic databases and conference meetings. We included thirteen retrospective studies and four randomized controlled trials, with PTBD performed in 2353 patients and EBD in 8178 patients. Outcomes of interest included: technical success rate, overall complications, 30-day mortality rate and risk of bleeding, pancreatitis, cholangitis and tube dislocation. Results: The differences in technical success rate, total complications, 30-day mortality rate and tube dislocation were not statistically significant between the two groups. Patients receiving PTBD showed a lower risk of pancreatitis (OR=0.14, 95%CI=0.06-0.31) and cholangitis (OR=0.52, 95%CI=0.30-0.90) when compared to EBD while PTBD was associated with higher risk of bleeding (OR=1.78; 95%CI=1.32-2.39). Conclusion: Our metaanalysis indicates the presence of some advantages and limits for both PTBD and EBD. We highlight the paucity of quality-of-life data, a vital element which should be carefully pondered in future studies and in choosing the optimal technique in patients with MOJ.
- Subjects
OBSTRUCTIVE jaundice; PERCUTANEOUS transhepatic cholangiography; RANDOMIZED controlled trials; SYSTEMATIC reviews; PANCREATIC cancer treatment; ELECTRONIC health records
- Publication
In Vivo, 2020, Vol 34, Issue 4, p1701
- ISSN
0258-851X
- Publication type
Article
- DOI
10.21873/invivo.11964