INTRODUCTION Preoperative biliary drainage has been widely used to treat patients with malignant biliary obstruction. However, it is still unclear which method is more effective: internal drainage or external drainage. Thus, we carried out a meta-analysis to compare the safety and efficacy of the two drainage methods in treatment of malignant biliary obstruction in terms of preoperative and postoperative complications. MATERIAL AND METHODS We conducted a literature search of Medline, EMBASE, PubMed, Ovid journals and the Cochrane Library, and compared internal drainage and external drainage in malignant biliary obstruction patients. The pre- and postoperative complications, stent dysfunction rate and mortality were analyzed. RESULTS Ten published studies (n = 1464 patients) were included in this meta-analysis. We found that patients with malignant biliary obstruction who received external drainage showed reductions in the preoperative cholangitis rate (OR = 0.33, 95% CI: 0.24-0.44, p < 0.00001), the incidence of stent dysfunction (OR = 0.41, 95% CI: 0.30-0.57, p < 0.00001), and total morbidity (OR = 0.34, 95% CI: 0.23-0.50, p < 0.00001) compared with patients who received internal drainage. CONCLUSIONS The current meta-analysis indicates that external drainage is better than internal drainage for malignant biliary obstruction in terms of the preoperative cholangitis rate, the incidence of stent dysfunction and total morbidity, etc. However, the findings need to be confirmed by randomized controlled trials.

中文翻译：

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内引流与外引流在姑息恶性胆道梗阻中的比较：荟萃分析和系统评价。

引言 术前胆道引流已广泛用于治疗恶性胆道梗阻患者。然而，目前还不清楚哪种方法更有效：内引流还是外引流。因此，我们进行了荟萃分析，从术前和术后并发症方面比较两种引流方法治疗恶性胆道梗阻的安全性和有效性。材料和方法 我们对 Medline、EMBASE、PubMed、Ovid 期刊和 Cochrane 图书馆进行了文献检索，比较了恶性胆道梗阻患者的内引流和外引流。分析术前术后并发症、支架功能障碍率及死亡率。结果 本荟萃分析纳入了 10 项已发表的研究（n = 1464 名患者）。我们发现接受外引流的恶性胆道梗阻患者术前胆管炎发生率（OR = 0.33，95% CI：0.24-0.44，p < 0.00001）、支架功能障碍发生率（OR = 0.41，95% CI： ：0.30-0.57，p < 0.00001），与接受内引流的患者相比，总发病率（OR = 0.34，95% CI：0.23-0.50，p < 0.00001）。结论 目前的荟萃分析表明，对于恶性胆道梗阻，外引流术在术前胆管炎发生率、支架功能障碍发生率和总发病率等方面均优于内引流术，但该结果有待随机对照试验的证实。 。