Preoperative biliary drainage in hilar cholangiocarcinoma: Systematic review and meta-analysis. Issue 9 (September 2017)

• Record Type: Journal Article
• Authors: Celotti, A.; Solaini, L.; Montori, G.; Coccolini, F.; Tognali, D.; Baiocchi, G.
• Is Part Of: European journal of surgical oncology. Volume 43:Issue 9(2017:Sep.)
• Page Start: 1628
• Page End: 1635
• Publication Date: 2017-09
• Subjects: Preoperative biliary drainage -- Klatskin tumor -- Hilar cholangiocarcinoma; PBD preoperative biliary drainage -- SSI surgical site infection -- FLR future liver remnant -- RCTs randomized controlled trials -- RR relative risk -- SMD standardized mean difference -- HCC hilar cholangiocarcinoma -- EDB endoscopic biliary drainage; Oncology -- Periodicals; Cancer -- Surgery -- Periodicals; Medical Oncology -- Periodicals; Neoplasms -- surgery -- Periodicals; Cancer -- Chirurgie -- Périodiques; Cancérologie -- Périodiques; Oncologie; Chirurgie (geneeskunde); Electronic journals; Electronic journals -- Sciences; Electronic journals -- Medicine; Electronic journals; 616.994059005
• DOI: 10.1016/j.ejso.2017.04.001
• Languages: English
• ISSNs: 0748-7983

Abstract

Abstract: Background: The role of preoperative biliary drainage (PBD) for hilar cholangiocarcinoma (HCC) remains unclear. The aim of this meta-analysis is to investigate the role of PBD in the treatment of potentially resectable HCC. Methods: All studies reporting outcomes on patients with PBD vs without PBD were included. A systematic literature search was performed in PubMed, Embase, and the Cochrane Library for studies published between 1980 and 2016. Results: Initial search identified 667 articles. Only 9 studies met the inclusion criteria and were included in this analysis. No significant differences in mortality were observed between the two groups (RR = 0, 935; 95% CI = 0, 612 to 1429; p = 0, 463). Overall morbidity was significantly higher in PBD group (RR = 1266; 95% CI = 1039 to 1543; p = 0, 011). No significant differences in transfusion rate, hospital stay, anastomotic leaks, abdominal collections and operative time, were found. Wound infections were significantly higher in PBD group. Conclusions: PBD seems to be associated with higher postoperative morbidity and increases the risk of wound infections. Further prospective studies are needed to better define the impact of PBD in outcomes after surgery for hilar cholangiocarcinoma.