The efficacy and safety of preoperative biliary drainage for hilar cholangiocarcinoma: A Meta-analysis

Abstract

Objective To evaluate the efficacy and safety of preoperative biliary drainage (PBD) for hilar cholangiocarcinoma (HC). Methods A thorough search of Cochrane Library, Medline, Embase, CBM, CNKI and WanFang database was performed. The literatures were screened according to the inclusion and exclusion criteria, and data processed for a meta-analysis by RevMan 5.2 software. Results Seventeen papers with a total number of 1 724 patients were included. Meta-analysis showed that there were no statistical differences between PBD and no preoperative biliary drainage (NPBD) in postoperative mortality, postoperative overall morbidity, postoperative infectious morbidity (wound infection, intra-abdominal infection, sepsis), postoperative noninfectious morbidity (bile leakage, abdominal hemorrhage), other perioperative outcomes (operative time intraoperative blood loss, postoperative hospital stay, curative resection rate) (all P>0.05). The incidence of liver failure in the PBD group was lower than that in the NPBD group (RR=0.50, 95%CI: 0.33-0.75, P<0.01). Conclusions PBD did not reduce the postoperative mortality and postoperative overall morbidity. However, PBD reduces the incidence of postoperative liver failure. Key words: Bile duct neoplasms; Drainage; Meta-analysis