Endoscopic unilateral versus bilateral biliary stenting for the palliation of malignant hilar obstruction: a meta-analysis

作者：Yubao Zhou, Jun Wu, Daoquan Zhang, Shu Jin, Xiang Zhan · 发表于：Zhonghua xiaohua neijing zazhi · 年份：2016 · DOI：10.3760/cma.j.issn.1007-5232.2016.01.010 · 研究领域：Gallbladder and Bile Duct Disorders、Esophageal and GI Pathology、Oral and gingival health research

Objective To evaluate the efficacy and safety of the unilateral and bilateral drainage in with a meta-analysis of relevant studies. Methods A systematic electronic search with keywords biliary stent, hilar tumor and malignant obstruction was independently performed by two reviewers in major electronic databases of Pubmed, EMBASE, Cochrane Library and Web of Science. A meta-analysis was conducted using Revman 5.1 software. Results Six studies were included with a total number of 558 patients, of whom 307 patients underwent unilateral drainage and 251 patients bilateral drainage. There was no significant difference in early complications (OR=1.03, 95%CI: 0.58-1.81, P=0.93), later complications (OR=0.98, 95%CI: 0.46-2.07, P=0.95), operation success rate (OR=1.42, 95%CI: 0.76-2.66, P=0.28), drainage efficacy or median survival time between the two groups. Compared with unilateral drainage, bilateral drainage had a longer time of stent patency (MD=-29.12, 95%CI: -38.55--19.70, P<0.001). Conclusion Both unilateral and bilateral drainage are safe and effective for obstruction, but more high quality clinical researches are needed. Key words: Cholestasis; Stents; Drainage; Program evaluation; Meta-Analysis