Hong Wandong, Chen Shanxi, Zhu Qihuai, Chen Huichun, Pan Jingye, Huang Qingke
Department of Gastroenterology and Hepatology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
Department of Radiology, Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China.
Clinics (Sao Paulo). 2014 Sep;69(9):647-52. doi: 10.6061/clinics/2014(09)12.
There is no consensus regarding the most appropriate methods (i.e., the side-by-side versus the stent-in-stent technique) for placing bilateral stents for malignant hilar biliary obstructions. We aimed to perform a quantitative review of the published data regarding the clinical efficacy of the side-by-side and stent-in-stent bilateral drainage techniques for hilar biliary obstructions.
A comprehensive search of several databases was conducted and a fixed-effects or random-effects model was used to pool the data from all of the study end-points.
Four clinical trials were identified. A comparison of the side-by-side and stent-in-stent groups revealed no significant differences with respect to the rates of successful placement, successful drainage, early complications, late complications and stent occlusions. There were also no significant inter-group differences in stent patency and patient survival and no publication bias was observed.
The performance of the side-by-side technique appears to be similar to that of the stent-in-stent technique for bilateral drainage in patients with malignant hilar biliary obstructions.
对于恶性肝门部胆管梗阻双侧支架置入的最合适方法（即并排技术与支架内支架技术），目前尚无共识。我们旨在对已发表的关于并排和支架内支架双侧引流技术治疗肝门部胆管梗阻临床疗效的数据进行定量综述。
对多个数据库进行全面检索，并使用固定效应或随机效应模型汇总所有研究终点的数据。
共确定了四项临床试验。并排组与支架内支架组在成功置入率、成功引流率、早期并发症、晚期并发症和支架闭塞方面无显著差异。在支架通畅率和患者生存率方面，组间也无显著差异，且未观察到发表偏倚。
对于恶性肝门部胆管梗阻患者的双侧引流，并排技术的表现似乎与支架内支架技术相似。
