中文｜English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 37 Issue 4
Apr.  2021
Turn off MathJax
Article Contents
Article Navigation >  Journal of Clinical Hepatology  > 2021  >  37(4): 863-867

Clinical effect of endoscopic nasobiliary drainage versus endoscopic biliary stenting in preoperative biliary drainage for low-level malignant obstructive jaundice: A Meta-analysis

DOI: 10.3969/j.issn.1001-5256.2021.04.027

  • Department of Hepatobiliary Surgery, Academician (Expert) Workstation of Sichuan Province, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, China

  • Received Date: 2020-09-24
  • Accepted Date: 2020-10-16
  • Published Date: 2021-04-20
    Abstract
  •   Objective  To investigate the clinical effect and safety of endoscopic nasobiliary drainage (ENBD) versus endoscopic biliary stenting (EBS) in preoperative biliary drainage for low-level malignant obstructive jaundice.  Methods  Chinese and English databases were searched for control studies on the clinical effect of ENBD versus EBS in preoperative biliary drainage for low-level malignant obstructive jaundice published up to August 2020. After quality assessment and data extraction were performed for the studies included, RevMan 5.3 software was used to perform the meta-analysis. ENBD and EBS were compared in terms of incidence rates of preoperative cholangitis and preoperative pancreatitis, stent dysfunction rate, overall incidence rate of complications before and after surgery, and rate of postoperative pancreatic leakage.  Results  Six studies involving 1182 patients were included. The meta-analysis showed that there were no significant differences between the ENBD group and the EBS group in incidence rate of preoperative pancreatitis (odds ratio [OR]=0.66, 95% confidence interval [CI]: 0.44-0.99, P=0.05), stent dysfunction rate (OR=1.14, 95% CI: 0.56-2.31, P=0.72), and overall incidence rate of complications before and after surgery (OR=0.69, 95% CI: 0.41-1.15, P=0.15). Compared with the EBS group, the ENBD group had significant reductions in incidence rate of preoperative cholangitis (OR=0.34, 95% CI: 0.23-0.50, P < 0.000 01) and rate of postoperative pancreatic leakage (OR=0.53, 95% CI: 0.32-0.88, P=0.01).  Conclusion  Preoperative biliary drainage with ENBD is superior to EBS in patients with well-diagnosed low-level malignant obstructive jaundice. More large multicenter randomized controlled trials are needed in the future to verify this conclusion.

     

    • FullText(HTML)
  • loading
    • References(26)
  • [1]
    PU LZ, SINGH R, LOONG CK, et al. Malignant biliary obstruction: Evidence for best practice[J]. Gastroenterol Res Pract, 2016, 2016: 3296801. DOI: 10.1155/2016/3296801.
    [2]
    CHEN WW, HUANG K, LIU R, et al. Clinical effect of percutaneous transhepatic cholangial drainage combined with biliary stent implantation in treatment of high malignant obstructive jaundice and the influencing factors for prognosis[J]. J Clin Hepatol, 2019, 35(3): 559-564. DOI: 10.3969/j.issn.1001-5256.2019.03.021.

    陈伟伟, 黄坤, 刘锐, 等. 经皮肝穿刺胆管引流术联合胆道支架植入术治疗高位恶性梗阻性黄疸的效果及预后影响因素分析[J]. 临床肝胆病杂志, 2019, 35(3): 559-564. DOI: 10.3969/j.issn.1001-5256.2019.03.021.
    [3]
    BERGQUIST A, VON SETH E. Epidemiology of cholangiocarcinoma[J]. Best Pract Res Clin Gastroenterol, 2015, 29(2): 221-232. DOI: 10.1016/j.bpg.2015.02.003.
    [4]
    YOSHIDA Y, AJIKI T, UENO K, et al. Preoperative bile replacement improves immune function for jaundiced patients treated with external biliary drainage[J]. J Gastrointest Surg, 2014, 18(12): 2095-2104. DOI: 10.1007/s11605-014-2674-2.
    [5]
    GUNDRY SR, STRODEL WE, KNOL JA, et al. Efficacy of preoperative biliary tract decompression in patients with obstructive jaundice[J]. Arch Surg, 1984, 119(6): 703-708. DOI: 10.1001/archsurg.1984.01390180065011.
    [6]
    COATES JM, BEAL SH, RUSSO JE, et al. Negligible effect of selective preoperative biliary drainage on perioperative resuscitation, morbidity, and mortality in patients undergoing pancreaticoduodenectomy[J]. Arch Surg, 2009, 144(9): 841-847. DOI: 10.1001/archsurg.2009.152.
    [7]
    ZHAO SW, SHEN ZY, WANG JC, et al. Effect of biliary drainage methods on patients with obstructive jaundice undergoing pancreaticoduodenectomy[J]. J Surg Concepts Pract, 2020, 25(4): 301-305. DOI: 10.16139/j.1007-9610.2020.04.007.

    赵诗葳, 沈子贇, 王建承, 等. 术前胆道引流方式对合并梗阻性黄疸病人胰十二指肠切除术的影响[J]. 外科理论与实践, 2020, 25(4): 301-305. DOI: 10.16139/j.1007-9610.2020.04.007.
    [8]
    CHOI SH, GWON DI, KO GY, et al. Hepatic arterial injuries in 3110 patients following percutaneous transhepatic biliary drainage[J]. Radiology, 2011, 261(3): 969-975. DOI: 10.1148/radiol.11110254.
    [9]
    MOHER D, LIBERATI A, TETZLAFF J, et al. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement[J]. PLoS Med, 2009, 6(7): e1000097. DOI: 10.1371/journal.pmed.1000097.
    [10]
    LUCHINI C, STUBBS B, SOLMI M, et al. Assessing the quality of studies in Meta-analyses: Advantages and limitations of the Newcastle Ottawa Scale[J]. World J Meta-Analysis, 2017, 5(4): 80-84. DOI: 10.13105/wjma.v5.i4.80.
    [11]
    FUJII T, YAMADA S, SUENAGA M, et al. Preoperative internal biliary drainage increases the risk of bile juice infection and pancreatic fistula after pancreatoduodenectomy: A prospective observational study[J]. Pancreas, 2015, 44(3): 465-470. DOI: 10.1097/MPA.0000000000000265.
    [12]
    HUANG X, LIANG B, ZHAO XQ, et al. The effects of different preoperative biliary drainage methods on complications following pancreaticoduodenectomy[J]. Medicine (Baltimore), 2015, 94(14): e723. DOI: 10.1097/MD.0000000000000723.
    [13]
    NAKAI Y, YAMAMOTO R, MATSUYAMA M, et al. Multicenter study of endoscopic preoperative biliary drainage for malignant hilar biliary obstruction: E-POD hilar study[J]. J Gastroenterol Hepatol, 2018, 33(5): 1146-1153. DOI: 10.1111/jgh.14050.
    [14]
    SASAHIRA N, HAMADA T, TOGAWA O, et al. Multicenter study of endoscopic preoperative biliary drainage for malignant distal biliary obstruction[J]. World J Gastroenterol, 2016, 22(14): 3793-3802. DOI: 10.3748/wjg.v22.i14.3793.
    [15]
    SUGIYAMA H, TSUYUGUCHI T, SAKAI Y, et al. Preoperative drainage for distal biliary obstruction: Endoscopic stenting or nasobiliary drainage?[J]. Hepatogastroenterology, 2013, 60(122): 231-234. DOI: 10.5754/hge12621.
    [16]
    ZHANG GQ, LI Y, REN YP, et al. Outcomes of preoperative endoscopic nasobiliary drainage and endoscopic retrograde biliary drainage for malignant distal biliary obstruction prior to pancreaticoduodenectomy[J]. World J Gastroenterol, 2017, 23(29): 5386-5394. DOI: 10.3748/wjg.v23.i29.5386.
    [17]
    van der GAAG NA, RAUWS EA, van EIJCK CH, et al. Preoperative biliary drainage for cancer of the head of the pancreas[J]. N Engl J Med, 2010, 362(2): 129-137. DOI: 10.1056/NEJMoa0903230.
    [18]
    SEWNATH ME, KARSTEN TM, PRINS MH, et al. A meta-analysis on the efficacy of preoperative biliary drainage for tumors causing obstructive jaundice[J]. Ann Surg, 2002, 236(1): 17-27. DOI: 10.1097/00000658-200207000-00005.
    [19]
    KARNABATIDIS D, SPILIOPOULOS S, KATSAKIORI P, et al. Percutaneous trans-hepatic bilateral biliary stenting in Bismuth Ⅳ malignant obstruction[J]. World J Hepatol, 2013, 5(3): 114-119. DOI: 10.4254/wjh.v5.i3.114.
    [20]
    BARKAY O, MOSLER P, SCHMITT CM, et al. Effect of endoscopic stenting of malignant bile duct obstruction on quality of life[J]. J Clin Gastroenterol, 2013, 47(6): 526-531. DOI: 10.1097/MCG.0b013e318272440e.
    [21]
    YAGIOKA H, HIRANO K, ISAYAMA H, et al. Clinical significance of bile cytology via an endoscopic nasobiliary drainage tube for pathological diagnosis of malignant biliary strictures[J]. J Hepatobiliary Pancreat Sci, 2011, 18(2): 211-215. DOI: 10.1007/s00534-010-0333-x.
    [22]
    HONG SK, JANG JY, KANG MJ, et al. Comparison of clinical outcome and cost-effectiveness after various preoperative biliary drainage methods in periampullary cancer with obstructive jaundice[J]. J Korean Med Sci, 2012, 27(4): 356-362. DOI: 10.3346/jkms.2012.27.4.356.
    [23]
    CORTES A, SAUVANET A, BERT F, et al. Effect of bile contamination on immediate outcomes after pancreaticoduodenectomy for tumor[J]. J Am Coll Surg, 2006, 202(1): 93-99. DOI: 10.1016/j.jamcollsurg.2005.09.006.
    [24]
    YU PH, SU S, CHEN S, et al. Clinical effect of pancreaticoduodenectomy with total mesopancreas excision versus traditional pancreaticoduodenecto-my in treatment of pancreatic head carcinoma and periampullary cancer: A meta-analysis[J]. J Clin Hepatol, 2020, 36(8): 1811-1815. DOI: 10.3969/j.issn.1001-5256.2020.08.026.

    余佩和, 苏松, 陈诗, 等. 胰十二指肠联合全系膜切除术与胰十二指肠切除术治疗胰头癌及壶腹周围癌效果比较的Meta分析[J]. 临床肝胆病杂志, 2020, 36(8): 1811-1815. DOI: 10.3969/j.issn.1001-5256.2020.08.026.
    [25]
    VELANOVICH V, KHEIBEK T, KHAN M. Relationship of postoperative complications from preoperative biliary stents after pancreaticoduodenectomy. A new cohort analysis and meta-analysis of modern studies[J]. JOP, 2009, 10(1): 24-29. http://www.ncbi.nlm.nih.gov/pubmed/19129611
    [26]
    KAWAI M, TANI M, HIRONO S, et al. Association of preoperative biliary drainage related complications with postoperative complications after pancreaticoduodenectomy[J]. HPB, 2014, 16: 111-112.
    • Relative Articles
    • Supplements(0)
    • Cited By
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(7)  / Tables(1)

    Get Citation
    PDF
    XML

    Article Metrics

    Article views (509) PDF downloads(36) Cited by()
    Proportional views
    Related
        

    The first journal specializing in hepatobiliary and pancreatic diseases in China

    Supervisor：Ministry of Education of the People's Republic of China

    Sponsor：Jilin University

    Academic Support: Chinese Society of Hepatology，Chinese Medical Association

    Address: 461 Xinjiang Road, Changchun

    Submit：0431-88782044

    Peer review：0431-88783542

    Email：lcgdb@vip.163.com

    About Journal

    Submission Guideline

    Journal Online

    Hepatobiliary College

    Guidelines

    YesterdayIP[]YesterdayPV[]TodayIP[]TodayPV[]Online[]

    Website Design © 2020 Editorial Board of Journal of Clinical Hepatology 吉ICP备10000617号-1 Supported by: Beijing Renhe Information Technology Co. Ltd  

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return