caa a22 4500 445794933 CHVBK 20180317145121.0 cr unu---uuuuu 170323e20110301xx s 000 0 eng 10.1007/s10620-010-1338-7 doi (NATIONALLICENCE)springer-10.1007/s10620-010-1338-7 Preoperative Biliary Drainage Before Resection for Hilar Cholangiocarcinoma: Whether or Not? A Systematic Review [Elektronische Daten] [Fei Liu, Ya Li, Yonggang Wei, Bo Li] Background: 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. Methods: 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. Results: 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 (CI) [1.17, 2.39]. In postoperative mortality analysis, ten studies including 422 patients who underwent PBD and 238 patients who had no PBD were estimated. The OR for postoperative mortality was 0.70: 95% CI [0.41, 1.19]. In postoperative infectious complications analysis, five studies including 134 patients who underwent PBD and 122 patients who had no PBD were estimated. The OR for infectious morbidity was 2.17: 95% CI [1.24, 3.80]. In postoperative hospital stay analysis, only three studies with 84 patients who underwent PBD and 65 patients who had no PBD were estimated; the weighted mean difference (WMD) for postoperative hospital stay was 5.37 days: 95% CI [−1.78, 12.52 days]. Conclusions: This systematic review could not provide evidence for a clinical benefit of using PBD in jaundiced patients with HCCA planned for surgery. Preoperative drainage should not routinely be performed in patients with proximal bile duct cancer scheduled for surgical resection. Because of the lack of uniformity of this analysis, randomized controlled trials (RCTs) with large sample size and improved PBD techniques should be carried out to confirm our results. Springer Science+Business Media, LLC, 2010 Hilar cholangiocarcinoma nationallicence Preoperative biliary drainage nationallicence Morbidity nationallicence Mortality nationallicence Hepatectomy nationallicence Systematic review nationallicence Liu Fei Department of Liver and Vascular Surgery, West China Hospital, Sichuan University, 37 Guo Xue Road, 610041, Chengdu, Sichuan Province, China aut Li Ya Division of Reproductive Endocrinology and Infertility, West China Second University Hospital, Sichuan University, 610041, Chengdu, Sichuan Province, China aut Wei Yonggang Department of Liver and Vascular Surgery, West China Hospital, Sichuan University, 37 Guo Xue Road, 610041, Chengdu, Sichuan Province, China aut Li Bo Department of Liver and Vascular Surgery, West China Hospital, Sichuan University, 37 Guo Xue Road, 610041, Chengdu, Sichuan Province, China aut Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/3(2011-03-01), 663-672 0163-2116 56:3<663 2011 56 10620 https://doi.org/10.1007/s10620-010-1338-7 text/html Onlinezugriff via DOI 1 review-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10620-010-1338-7 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Liu Fei Department of Liver and Vascular Surgery, West China Hospital, Sichuan University, 37 Guo Xue Road, 610041, Chengdu, Sichuan Province, China aut NATIONALLICENCE 700 1- Li Ya Division of Reproductive Endocrinology and Infertility, West China Second University Hospital, Sichuan University, 610041, Chengdu, Sichuan Province, China aut NATIONALLICENCE 700 1- Wei Yonggang Department of Liver and Vascular Surgery, West China Hospital, Sichuan University, 37 Guo Xue Road, 610041, Chengdu, Sichuan Province, China aut NATIONALLICENCE 700 1- Li Bo Department of Liver and Vascular Surgery, West China Hospital, Sichuan University, 37 Guo Xue Road, 610041, Chengdu, Sichuan Province, China aut NATIONALLICENCE 773 0- Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/3(2011-03-01), 663-672 0163-2116 56:3<663 2011 56 10620 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer