The efficacy and safety of preoperative biliary drainage for hilar cholangiocarcinoma: A Meta-analysis / 中华普通外科杂志

ABSTRACT

Objective To evaluate the efficacy and safety of preoperative biliary drainage (PBD) for hilar cholangiocarcinoma (HC).Methods A thorough search of Cochrane Library,Medline,Embase,CBM,CNKI and WanFang database was performed.The literatures were screened according to the inclusion and exclusion criteria,and data processed for a meta-analysis by RevMan 5.2 software.Results Seventeen papers with a total number of 1 724 patients were included.Meta-analysis showed that there were no statistical differences between PBD and no preoperative biliary drainage (NPBD) in postoperative mortality,postoperative overall morbidity,postoperative infectious morbidity (wound infection,intra-abdominal infection,sepsis),postoperative noninfectious morbidity (bile leakage,abdominal hemorrhage),other perioperative outcomes (operative time intraoperative blood loss,postoperative hospital stay,curative resection rate) (all P ＞ 0.05).The incidence of liver failure in the PBD group was lower than that in the NPBD group (RR =0.50,95％ CI0.33-0.75,P ＜ 0.01).Conclusions PBD did not reduce the postoperative mortality and postoperative overall morbidity.However,PBD reduces the incidence of postoperative liver failure.