Endoscopic Biliary Darinage (EBD) versus Percutaneous Transhepatic Biliary Drainage (PTBD) for biliary drainage in patients with Perihilar Cholangiocarcinoma (PCCA): A systematic review and meta-analysis

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art_MOLL_Endoscopic_Biliary_Darinage_EBD_versus_Percutaneous_Transhepatic_Biliary_.PDF (2.2 MB)
Citações na Scopus
1
Tipo de produção
article
Data de publicação
2023
DOI
SciELO
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
ELSEVIER ESPANA
Autores
SANCHEZ-LUNA, Sergio A.
Citação
CLINICS, v.78, article ID 100163, 9p, 2023
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Biliary drainage for Perihilar Cholangiocarcinoma (PCCA) can be performed either by endoscopic retrograde chol-angiopancreatography or Percutaneous Transhepatic Biliary Drainage (PTBD). To date there is no consensus about which method is preferred. Taking that into account, the aim of this study is to compare Endoscopic Biliary Drainage (EBD) versus percutaneous transhepatic biliary drainage in patients with perihilar cholangiocarcinoma through a systematic review and metanalysis. A comprehensive search of multiple electronic databases was per-formed. Evaluated outcomes included technical success, clinical success, post drainage complications (cholangitis, pancreatitis, bleeding, and major complications), crossover, hospital length stay, and seeding metastases. Data extracted from the studies were used to calculate Mean Differences (MD). Seventeen studies were included, with a total of 2284 patients (EBD = 1239, PTBD = 1045). Considering resectable PCCA, the PTBD group demon-strated lower rates of crossover (RD = 0.29; 95% CI 0.07-0.51; p = 0.009 I2 = 90%), post-drainage complica-tions (RD = 0.20; 95% CI 0.06-0.33; p < 0.0001; I2 = 78%), and post-drainage pancreatitis (RD = 0.10; 95% CI 0.05-0.16; p < 0.0001; I2 = 64%). The EBD group presented reduced length of hospital stay (RD =-2.89; 95% CI-3.35 --2,43;p < 0.00001; I2 = 42%). Considering palliative PCCA, the PTBD group demonstrated a higher clini-cal success (RD =-0.19; 95% CI-0.27 --0.11;p < 0.00001; I2 = 0%) and less post-drainage cholangitis (RD = 0.08; 95% CI 0.01-0.15; p = 0.02; I2 = 48%) when compared to the EBD group. There was no statistical difference between the groups regarding: technical success, post-drainage bleeding, major post-drainage compli-cations, and seeding metastases.
Palavras-chave
Endoscopic retrograde, cholangiopancreatography, Percutaneous transhepatic biliary drainage, Cholangiocarcinoma, Klatskin, Biliary, Stent, Drainage Cancer
URI
https://observatorio.fm.usp.br/handle/OPI/53174
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Coleções
Artigos e Materiais de Revistas Científicas - HC/ICHC
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