Is percutaneous drainage better than endoscopic drainage in the management of patients with malignant obstructive jaundice? A meta-analysis of RCTs

Bian, Cnogwen; Fang, Yuan; Xia, Jun; Shi, Lei; Huang, Hanfei; Xiong, Qiru; Wu, Ruolin; Zhong, Zhang

doi:10.3389/fonc.2023.1105728

Cited by 2 publications

(1 citation statement)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Some scholars have also reported that the incidence of postoperative complication rates is as high as 30% to 50% for PTCD, compared to only about 5% for ERCP ( 38 ). The results of the meta-analysis showed that although the overall complication rate was higher in the PTCD group than in the ERCP group, it was not statistically significant, which is inconsistent with the results of some previous studies ( 39 , 40 ). It may be due to the uneven grouping of some studies, which led to a bias towards patients with high levels of obstruction.…”

Section: Discussioncontrasting

confidence: 95%

The clinical efficacy and safety of different biliary drainage in malignant obstructive jaundice: a meta-analysis

Wang,

Zhao,

She

et al. 2024

Front. Oncol.

View full text Add to dashboard Cite

BackgroundCurrently, percutaneous transhepatic cholangial drainage (PTCD) and endoscopic retrograde cholangiopancreatography (ERCP) are commonly employed in clinical practice to alleviate malignant obstructive jaundice (MOJ). Nevertheless, there lacks a consensus regarding the superiority of either method in terms of efficacy and safety.AimTo conduct a systematic evaluation of the effectiveness and safety of PTCD and ERCP in treating MOJ, and to compare the therapeutic outcomes and safety profiles of these two procedures.MethodsCNKI, VIP, Wanfang, CBM, PubMed, Web of Science, Embase, The Cochrane Library, and other databases were searched for randomized controlled trials (RCTs) on the use of PTCD or ERCP for MOJ. The search period was from the establishment of the databases to July 2023. After quality assessment and data extraction from the included studies, Meta-analysis was performed using RevMan5.3 software.ResultsA total of 21 RCTs involving 1,693 patients were included. Meta-analysis revealed that there was no significant difference in the surgical success rate between the two groups for patients with low biliary obstruction (P=0.81). For patients with high biliary obstruction, the surgical success rate of the PTCD group was higher than that of the ERCP group (P < 0.0001), and the overall surgical success rate of the PTCD group was also higher than that of the ERCP group (P = 0.008). For patients with low biliary obstruction, the rate of jaundice relief (P < 0.00001) and the clinical efficacy (P = 0.0005) were better in the ERCP group, while for patients with high biliary obstruction, the rate of jaundice relief (P < 0.00001) and the clinical efficacy (P = 0.003) were better in the PTCD group. There was no significant difference in the overall jaundice remission rate and clinical efficacy between the two groups (P = 0.77, 0.53). There was no significant difference in the reduction of ALT, TBIL, and DBIL before and after surgery and the incidence of postoperative complications between the two groups (P > 0.05).ConclusionBoth PTCD and ERCP can efficiently alleviate biliary obstruction and enhance liver function. ERCP is effective in treating low biliary obstruction, while PTCD is more advantageous in treating high biliary obstruction.

show abstract

Section: Discussioncontrasting

confidence: 95%