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- W2894831416 abstract "Introduction: The merits of selecting preoperative endoscopic above percutaneous trans-hepatic biliary drainage (BD) for jaundiced patients awaiting pancreatoduodenectomy (PD) remain controversial. The aim of this systematic review was to compare the risk of postoperative complications in patients who underwent PD after either percutaneous or endoscopic BD. Methods: Data from studies published until November 2017 and comparing the rate of postoperative complications in patients who underwent endoscopic or percutaneous BD before PD was extracted independently by two investigators. The primary outcome compared in the meta-analysis of the obtained data was the risk of post-PD complications. Secondary outcomes were the risks of procedure related complications, postoperative mortality, postoperative pancreatic fistula (POPF), severe complications and wound infection. Odds ratio (OR) and 95% confidence interval (C.I.) were calculated for dichotomous variables and compared between groups using Forrest plots with Mantel-Haenszel method. Results: 13 studies, including 2334 patients (501 in the percutaneous and 1833 in the endoscopic group), fulfilled the inclusion criteria. Post-operative morbidity and procedure related complications rates were significantly lower in the percutaneous group (OR 0.7, 95% c.i. 0.52 to 0.94, p=0.02 and OR 0.44, 95% c.i. 0.23 to 0.84, p=0.01 respectively). No significant differences were observed when severe post-operative complications, postoperative mortality, POPF and wound infection rates were compared. Conclusions: In patients awaiting PD, the use of preoperative percutaneous biliary drain is associated with less procedure-related and postoperative complications than endoscopic drain, but does not reduce major postoperative complications rate and mortality." @default.
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- W2894831416 date "2018-09-01" @default.
- W2894831416 modified "2023-10-18" @default.
- W2894831416 title "Is percutaneous transhepatic biliary drainage better than endoscopic drainage in the management of Jaundiced patients awaiting pancreaticoduodenectomy? A systematic review and meta-analysis" @default.
- W2894831416 doi "https://doi.org/10.1016/j.hpb.2018.06.368" @default.
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