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恶性胆管梗阻的胆管引流技术比较:一项荟萃分析

Comparison of Biliary Drainage Techniques for MBO: A Meta-Analysis.

作者信息

Qiu Feng, Yang Tianchi, Han Wei

机构信息

Department of General Surgery, Beijing Luhe Hospital, Capital Medical University, Tongzhou, Beijing 101149, China.

出版信息

Pancreas. 2025 Jun 25;54(9):e796-805. doi: 10.1097/MPA.0000000000002504.

Abstract

BACKGROUND

Malignant biliary obstruction (MBO) impacts patient health and quality of life. Biliary drainage techniques, including percutaneous transhepatic biliary drainage (PTBD) and endoscopic biliary drainage (EBD), are commonly used, yet their relative advantages remain unclear.

OBJECTIVE

To compare the effectiveness and complications of EBD and PTBD in treating MBO.

METHODS

A systematic literature search in databases such as PubMed and EMBASE identified case-control trials comparing EBD and PTBD from January 2010 to the present. Five studies comprising 721 participants were analyzed. Outcome measures included technical success rate, incidence of complications, post-drainage pancreatitis, bleeding, major complications, hospital stay duration, and implant metastasis rates. Statistical analysis was conducted using RevMan 5.3 software.

RESULTS

There was no significant difference between the two groups regarding major complications, bleeding incidents, hospital stay, or implantation metastasis rates. However, PTBD showed a significantly lower incidence of complications and post-drainage pancreatitis compared to EBD.

CONCLUSION

PTBD may offer advantages over EBD in managing MBO, including fewer complications and reduced incidence of pancreatitis, suggesting PTBD as a potentially safer and more effective treatment option. Nonetheless, further large-scale, high-quality studies are needed to validate these findings.

摘要

背景

恶性胆管梗阻(MBO)会影响患者的健康和生活质量。包括经皮经肝胆道引流(PTBD)和内镜下胆道引流(EBD)在内的胆道引流技术被广泛应用,但其相对优势仍不明确。

目的

比较EBD和PTBD治疗MBO的有效性和并发症。

方法

在PubMed和EMBASE等数据库中进行系统文献检索,以确定2010年1月至今比较EBD和PTBD的病例对照试验。分析了五项包含721名参与者的研究。观察指标包括技术成功率、并发症发生率、引流后胰腺炎、出血、严重并发症、住院时间和植入转移率。使用RevMan 5.3软件进行统计分析。

结果

两组在严重并发症、出血事件、住院时间或植入转移率方面无显著差异。然而,与EBD相比,PTBD的并发症和引流后胰腺炎发生率显著更低。

结论

在处理MBO方面,PTBD可能优于EBD,包括并发症更少和胰腺炎发生率更低,这表明PTBD是一种潜在更安全、更有效的治疗选择。尽管如此,仍需要进一步的大规模、高质量研究来验证这些发现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/354c/12419004/674780b2cce9/mpa-54-e796-g001.jpg

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