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Bilateral vs unilateral placement of metal stents for inoperable high-grade hilar biliary strictures: A systemic review and meta-analysis.
- Source :
-
World journal of gastroenterology [World J Gastroenterol] 2019 Sep 14; Vol. 25 (34), pp. 5210-5219. - Publication Year :
- 2019
-
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.<br />Aim: To assess the efficacy and safety of bilateral vs unilateral biliary drainage in inoperable malignant hilar obstruction.<br />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.<br />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.<br />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.<br />Competing Interests: Conflict-of-interest statement: No conflict of interest to declare. No financial support was received for the study.
- Subjects :
- Bile Duct Neoplasms surgery
Cholestasis etiology
Constriction, Pathologic etiology
Constriction, Pathologic surgery
Drainage adverse effects
Drainage instrumentation
Hepatic Duct, Common pathology
Hepatic Duct, Common surgery
Humans
Klatskin Tumor surgery
Postoperative Complications epidemiology
Postoperative Complications etiology
Reoperation statistics & numerical data
Stents adverse effects
Time Factors
Treatment Outcome
Bile Duct Neoplasms complications
Cholestasis surgery
Drainage methods
Klatskin Tumor complications
Palliative Care methods
Subjects
Details
- Language :
- English
- ISSN :
- 2219-2840
- Volume :
- 25
- Issue :
- 34
- Database :
- MEDLINE
- Journal :
- World journal of gastroenterology
- Publication Type :
- Academic Journal
- Accession number :
- 31558868
- Full Text :
- https://doi.org/10.3748/wjg.v25.i34.5210