Bilateral vs unilateral placement of metal stents for inoperable high-grade hilar biliary strictures: A systemic review and meta-analysis.
World J Gastroenterol
; 25(34): 5210-5219, 2019 Sep 14.
Article
em En
| MEDLINE
| ID: mdl-31558868
ABSTRACT
BACKGROUND:
Bilateral vs unilateral biliary stenting is used for palliation in malignant biliary obstruction. No clear data is available to compare the efficacy and safety of bilateral biliary stenting over unilateral stenting.AIM:
To assess the efficacy and safety of bilateral vs unilateral biliary drainage in inoperable malignant hilar obstruction.METHODS:
PubMed, Embase, Scopus, and Cochrane databases, as well as secondary sources (bibliographic review of selected articles and major GI proceedings), were searched through January 2019. The primary outcome was the re-intervention rate. Secondary outcomes were a technical success, early and late complications, and stent malfunction rate. Pooled odds ratio (OR) and 95% confidence interval (CI) were calculated for each outcome.RESULTS:
A total of 9 studies were included (2 prospective Randomized Controlled Study, 5 retrospective studies, and 2 abstracts), involving 782 patients with malignant hilar obstruction. Bilateral stenting had significantly lower re-intervention rate compared with unilateral drainage (OR = 0.59, 95%CI 0.40-0.87, P = 0.009). There was no difference in the technical success rate (OR = 0.7, CI 0.42-1.17, P = 0.17), early complication rate (OR = 1.56, CI 0.31-7.75, P = 0.59), late complication rate (OR = 0.91, CI 0.58-1.41, P = 0.56) and stent malfunction (OR = 0.69, CI 0.42-1.12, P = 0.14) between bilateral and unilateral stenting for malignant hilar biliary strictures.CONCLUSION:
Bilateral biliary drainage had a lower re-intervention rate as compared to unilateral drainage for high grade inoperable malignant biliary strictures, with no significant difference in technical success, and early or late complication rates.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Cuidados Paliativos
/
Neoplasias dos Ductos Biliares
/
Drenagem
/
Colestase
/
Tumor de Klatskin
Tipo de estudo:
Clinical_trials
/
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
/
Systematic_reviews
Limite:
Humans
Idioma:
En
Revista:
World J Gastroenterol
Assunto da revista:
GASTROENTEROLOGIA
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
Estados Unidos