Unilateral versus bilateral biliary drainage for malignant hilar obstruction: a systematic review and meta-analysis / 中华肝脏病杂志
Chinese Journal of Hepatology
;
(12): 118-123, 2015.
Artículo
en Chino
| WPRIM
| ID: wpr-337028
ABSTRACT
<p><b>OBJECTIVE</b>To assess the efficacy and safety of bilateral versus unilateral biliary drainage in malignant hilar obstruction.</p><p><b>METHODS</b>Topically relevant studies,regardless of randomized or observational design, were searched for in PubMed, EmBase and the Cochrane Library database. Risk ratios (RRs) with 95% confidence intervals (CIs) were calculated to compare the effect of the two treatments.</p><p><b>RESULTS</b>Three randomized trials and 7 observational studies were included, involving 894 patients with malignant hilar obstruction. The meta-analysis assessment of primary outcomes showed that the stent patency rate was better in bilateral drainage than in unilateral drainage (Rr=2.03,95% CI [1.16-3.56], P=0.01), but there were no significant differences in successful drainage rate (Rr=1.07,95% CI [0.97-1.18], P=0.20) and patient survival rate (Rr=-0.16,95% CI [-0.40-0.08], P=0.20). In the analysis of secondary outcomes,there were also no significant differences in the technical success rate (Rr=1.05,95% CI [0.98-1.17], P=0.34),the early complication rate (Rr=1.15, 95% CI [0.75-1.76], P=0.52), late complication rate (Rr=1.09,95% CI [0.75-1.60], P=0.60) and 30-day mortality rate (Rr=0.68,95% CI [0.38-1.23], P=0.20).</p><p><b>CONCLUSION</b>Although the cumulative stent patency was better for the bilateral than the unilateral drainage approach, based on the available data, there is not enough data to support bilateral drainage for malignant hilar obstruction. Well-designed randomized controlled trials are necessary to confirm it.</p>
Texto completo:
Disponible
Índice:
WPRIM (Pacífico Occidental)
Asunto principal:
Patología
/
Terapéutica
/
Neoplasias del Sistema Biliar
/
Drenaje
/
Colestasis
/
Métodos
Tipo de estudio:
Ensayo Clínico Controlado
/
Estudio observacional
/
Revisiones Sistemáticas Evaluadas
Límite:
Humanos
Idioma:
Chino
Revista:
Chinese Journal of Hepatology
Año:
2015
Tipo del documento:
Artículo
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