Preoperative biliary drainage before resection for hilar cholangiocarcinoma: whether or not? A systematic review.

Digestive Diseases and Sciences
Fei LiuBo Li

Abstract

The value of preoperative biliary drainage (PBD) before resection for hilar cholangiocarcinoma (HCCA) is still controversial nowadays. The objective of this review is to summarize quantitatively the evidence related to this issue. Two investigators independently searched the Medline, Embase, Academic Search Premier (EBSCO), Chinese BioMedical Literature on disc (CBMdisc), and Chinese Medical Current Contents (CMCC) databases. Eleven studies with a total number of 711 HCCA cases were included. Comparison was made of PBD versus no PBD in HCCA patients undergoing surgical resection. Outcome measures were postoperative complications, in-hospital death rate, postoperative infectious complications, and postoperative hospital stay. There was no difference in death rate or postoperative hospital stay between the two treatment modalities. However, the overall postoperative complication rate and postoperative infectious complication rate were significantly adversely affected by PBD compared with surgery without PBD. In postoperative complications analysis, ten studies including 442 patients who underwent PBD and 233 patients who had no PBD were estimated. The odds ratio (OR) for postoperative morbidity was 1.67: 95% confidence interval (...Continue Reading

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