Effects of different preoperative biliary drainage methods for resected malignant obstruction jaundice on the incidence rate of implantation metastasis: A meta‑analysis

Yang,Gang; Xiong,Yongfu; Sun,Ji; Tang,Tao; Li,Weinan; Wang,Guan; Li,Jingdong

doi:10.3892/ol.2020.11767

Effects of different preoperative biliary drainage methods for resected malignant obstruction jaundice on the incidence rate of implantation metastasis: A meta‑analysis

Authors:
- Gang Yang
- Yongfu Xiong
- Ji Sun
- Tao Tang
- Weinan Li
- Guan Wang
- Jingdong Li
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Affiliations: Department of Hepatocellular Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637007, P.R. China, Physical Examination Center, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637007, P.R. China
Published online on: June 24, 2020 https://doi.org/10.3892/ol.2020.11767
Pages: 2217-2224
Copyright: © Yang et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

The aim of the present study was to compare the effects of percutaneous transhepatic biliary drainage (PTBD) and endoscopic biliary drainage (EBD) for resected malignant obstruction jaundice (MOJ) on the incidence rate of implantation metastasis. Databases including PubMed, EMbase, Web of Science and Cochrane Library were utilized. With reference to literature reported until January 2019, controlled clinical trials were designed to compare the effects of PTBD and EBD for MOJ on the incidence rate of implantation metastasis. Subsequently, odds ratio (OR) with 95% confidence interval (CI) was calculated with Review Manager 5.3.0 software. A total of 10 studies were enrolled in this meta‑analysis, including 1,085 cases in the PTBD group and 1,379 cases in the EBD group. The results revealed that there was a significant difference in the incidence rate of implantation metastasis between the PTBD group and EBD group (OR=0.35, 95% CI: 0.23‑0.53, P<0.00001). Subgroup analysis revealed that the incidence rates of both catheter‑related implantation metastasis and peritoneal metastasis were lower in the EBD group (OR=0.23, 95% CI: 0.12‑0.44, P<0.00001; OR=0.47, 95% CI: 0.31‑0.74, P=0.0008, respectively), and the advantage of EBD was demonstrated in perihilar cholangiocarcinoma, distal cholangiocarcinoma and pancreatic carcinoma (OR=0.35, 95% CI: 0.17‑0.74, P=0.006; OR=0.32, 95% CI: 0.17‑0.60, P=0.0005; OR=0.27, 95% CI: 0.19‑0.40, P<0.00001, respectively). In conclusion, this meta‑analysis revealed the appropriate choice of preoperative biliary drainage for resected MOJ. The application of EBD reduced the incidence rate of implantation metastasis, however more evidence is required from future studies, to confirm the results.

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