eISSN: 2299-0054
ISSN: 1895-4588
Videosurgery and Other Miniinvasive Techniques
Current issue Archive Videoforum Manuscripts accepted About the journal Supplements Editorial board Journal's reviewers Abstracting and indexing Subscription Contact Instructions for authors Ethical standards and procedures
SCImago Journal & Country Rank

 
3/2021
vol. 16
 
Share:
Share:
more
 
 
abstract:
Meta-analysis

Endoscopic metal stenting for malignant hilar biliary obstruction: an update meta-analysis of unilateral versus bilateral stenting

Fang Yang
1
,
Xue-Min Wang
2
,
Feng-Fei Xia
3
,
Xin-Qiang Han
4

1.
Department of Infectious and Liver Disease, Binzhou Medical University Hospital, Binzhou, China
2.
Department of Digestion, Binzhou Medical University Hospital, Binzhou, China
3.
Department of Interventional Vascular Surgery, Binzhou People’s Hospital, Binzhou, China
4.
Department of Interventional Vascular Surgery, Binzhou Medical University Hospital, Binzhou, China
Videosurgery Miniinv 2021; 16 (3): 472–481
Online publish date: 2021/03/08
View full text
Get citation
ENW
EndNote
BIB
JabRef, Mendeley
RIS
Papers, Reference Manager, RefWorks, Zotero
AMA
APA
Chicago
Harvard
MLA
Vancouver
 
Introduction
Malignant hilar biliary obstruction (MHBO) can arise in patients with malignant hilar hepatobiliary tumors or lymph nodules. Most MHBO patients are not suitable for surgical resection due to the advanced tumor stage. The only palliative treatment available is provided by endoscopic or percutaneous stenting. Aim: To compare the efficacy of endoscopic unilateral versus bilateral metal stent insertion for treating MHBO.

Material and methods
A search of the PubMed, Embase, and Cochrane Library databases identified all relevant studies published until June 2020. The meta-analysis was undertaken using RevMan v5.3.

Results
We identified 154 studies initially, eight of which were used in our meta-analysis. The eight studies included 818 MHBO patients treated using either endoscopic unilateral (n = 396) or bilateral (n = 422) metal stenting. No significant differences were observed between the two groups in clinical success rate (OR = 2.64; p = 0.18), complication rate (OR = 0.63; p = 0.46), or OS (HR = 1.03; p = 0.53). The bilateral group had a lower stent dysfunction rate without significance (OR = 1.43; p = 0.09). Significantly longer stent patency was observed in the bilateral group (HR = 1.28; p = 0.01). Technical success rate was significantly higher in the unilateral group (OR = 0.26; p = 0.04). Funnel plot analysis indicated an absence of publication bias related to the selected study endpoints.

Conclusions
Our meta-analysis indicated that endoscopic unilateral stenting had a greater technical success rate for MHBO patients than bilateral stenting. However, the bilateral stenting could achieve longer stent patency.

keywords:

stent, endoscopic, malignant hilar biliary obstruction, unilateral, bilateral

  
Quick links
© 2021 Termedia Sp. z o.o. All rights reserved.
Developed by Bentus.
PayU - płatności internetowe