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Percutaneous transhepatic and endoscopic biliary drainage for malignant biliary tract obstruction: a meta-analysis

BACKGROUND: Various malignant tumors can obstruct the extrahepatic biliary tract. Two major techniques for restoring bile flow in this circumstance are endoscopic biliary drainage (EBD) and percutaneous transhepatic biliary drainage (PTBD).We conducted a meta-analysis to compare the effectiveness an...

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Autores principales: Leng, Jian-jun, Zhang, Ning, Dong, Jia-hong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6389255/
https://www.ncbi.nlm.nih.gov/pubmed/25148939
http://dx.doi.org/10.1186/1477-7819-12-272
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author Leng, Jian-jun
Zhang, Ning
Dong, Jia-hong
author_facet Leng, Jian-jun
Zhang, Ning
Dong, Jia-hong
author_sort Leng, Jian-jun
collection PubMed
description BACKGROUND: Various malignant tumors can obstruct the extrahepatic biliary tract. Two major techniques for restoring bile flow in this circumstance are endoscopic biliary drainage (EBD) and percutaneous transhepatic biliary drainage (PTBD).We conducted a meta-analysis to compare the effectiveness and safety of the two techniques. METHODS: Medline, EMBASE and the Cochrane Library database were searched for articles published between January 1980 and December 2013. The outcome measures were therapeutic success rate (primary), 30-day mortality rate and overall complications. RESULTS: Of 264 screened articles, 3 randomized controlled trials comprising an aggregate total of 183 cancer patients were included in the meta-analysis. Our analysis showed no significant difference in restoration of bile flow between patients treated with EBD and those treated with PTBD (odds ratio (OR) = 2.34, 95% confidence interval (CI) = 0.32 to 17.16, P = 0.401). However, the result of sensitivity analysis indicated that the study conducted by Speer et al. influenced the pooled estimates. After the Speer et al. study was excluded, the therapeutic success rate of patients treated with PTBD was significantly greater than that of those who underwent EBD (OR = 5.48, 95% CI: 2.26 to 13.28, P < 0.001). The 30-day mortality and complication rates were similar in the EBD and PTBD groups. CONCLUSIONS: The results of our meta-analysis indicate that PTBD had a higher therapeutic success rate than EBD in the treatment of malignancy-induced biliary obstruction. The mortality and complication rates of the two techniques were similar. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/1477-7819-12-272) contains supplementary material, which is available to authorized users.
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spelling pubmed-63892552019-03-19 Percutaneous transhepatic and endoscopic biliary drainage for malignant biliary tract obstruction: a meta-analysis Leng, Jian-jun Zhang, Ning Dong, Jia-hong World J Surg Oncol Research BACKGROUND: Various malignant tumors can obstruct the extrahepatic biliary tract. Two major techniques for restoring bile flow in this circumstance are endoscopic biliary drainage (EBD) and percutaneous transhepatic biliary drainage (PTBD).We conducted a meta-analysis to compare the effectiveness and safety of the two techniques. METHODS: Medline, EMBASE and the Cochrane Library database were searched for articles published between January 1980 and December 2013. The outcome measures were therapeutic success rate (primary), 30-day mortality rate and overall complications. RESULTS: Of 264 screened articles, 3 randomized controlled trials comprising an aggregate total of 183 cancer patients were included in the meta-analysis. Our analysis showed no significant difference in restoration of bile flow between patients treated with EBD and those treated with PTBD (odds ratio (OR) = 2.34, 95% confidence interval (CI) = 0.32 to 17.16, P = 0.401). However, the result of sensitivity analysis indicated that the study conducted by Speer et al. influenced the pooled estimates. After the Speer et al. study was excluded, the therapeutic success rate of patients treated with PTBD was significantly greater than that of those who underwent EBD (OR = 5.48, 95% CI: 2.26 to 13.28, P < 0.001). The 30-day mortality and complication rates were similar in the EBD and PTBD groups. CONCLUSIONS: The results of our meta-analysis indicate that PTBD had a higher therapeutic success rate than EBD in the treatment of malignancy-induced biliary obstruction. The mortality and complication rates of the two techniques were similar. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/1477-7819-12-272) contains supplementary material, which is available to authorized users. BioMed Central 2014-08-23 /pmc/articles/PMC6389255/ /pubmed/25148939 http://dx.doi.org/10.1186/1477-7819-12-272 Text en © Leng et al. 2014 This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Leng, Jian-jun
Zhang, Ning
Dong, Jia-hong
Percutaneous transhepatic and endoscopic biliary drainage for malignant biliary tract obstruction: a meta-analysis
title Percutaneous transhepatic and endoscopic biliary drainage for malignant biliary tract obstruction: a meta-analysis
title_full Percutaneous transhepatic and endoscopic biliary drainage for malignant biliary tract obstruction: a meta-analysis
title_fullStr Percutaneous transhepatic and endoscopic biliary drainage for malignant biliary tract obstruction: a meta-analysis
title_full_unstemmed Percutaneous transhepatic and endoscopic biliary drainage for malignant biliary tract obstruction: a meta-analysis
title_short Percutaneous transhepatic and endoscopic biliary drainage for malignant biliary tract obstruction: a meta-analysis
title_sort percutaneous transhepatic and endoscopic biliary drainage for malignant biliary tract obstruction: a meta-analysis
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6389255/
https://www.ncbi.nlm.nih.gov/pubmed/25148939
http://dx.doi.org/10.1186/1477-7819-12-272
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