Literature DB >> 25040581

Comparison of percutaneous transhepatic biliary drainage and endoscopic biliary drainage in the management of malignant biliary tract obstruction: a meta-analysis.

Xiang-qian Zhao1, Jia-hong Dong, Kai Jiang, Xiao-qiang Huang, Wen-zhi Zhang.   

Abstract

BACKGROUND AND AIM: To compare percutaneous transhepatic biliary drainage (PTBD) and endoscopic biliary drainage (EBD) for management of malignant biliary tract obstruction (MBTO).
METHODS: PubMed, Google Scholar, and the Cochrane database were searched to 31 December 2013. Main outcome measurements were therapeutic success rate, 30-day mortality rate, overall complications, cholangitis, and pancreatitis.
RESULTS: Eight studies (five retrospective and three randomized controlled trials) were included in the meta-analysis with a total of 692 participants. Combined odds ratio (OR) = 2.18 revealed no significant difference in therapeutic success between PTBD and EBD (95% confidence interval [CI] = 0.73-6.47, P = 0.162). However, after excluding two studies that appeared to be outliers, PTBD exhibited a better therapeutic success rate than EBD (pooled OR = 4.45, 95% CI = 2.68-7.40, P < 0.001). Patients who underwent PTBD were 0.55 times as likely to have cholangitis as those who underwent EBD, whereas the overall complication rate, pancreatitis rate, and 30-day mortality were similar between the two procedures.
CONCLUSIONS: PTBD may be associated with a better therapeutic success rate and lower incidence of cholangitis than EBD, but the overall complication rate, pancreatitis rate, and 30-day mortality of the two procedures are similar.
© 2014 The Authors. Digestive Endoscopy © 2014 Japan Gastroenterological Endoscopy Society.

Entities:  

Keywords:  endoscopic biliary drainage; malignant biliary tract obstruction; meta-analysis; percutaneous transhepatic biliary drainage

Mesh:

Year:  2014        PMID: 25040581     DOI: 10.1111/den.12320

Source DB:  PubMed          Journal:  Dig Endosc        ISSN: 0915-5635            Impact factor:   7.559


  34 in total

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