000			02908nam a22004577a 4500
008			170411s20162016 xxu||||| |||| 00| 0 eng d
022			_a2291-2789
040			_aOvid MEDLINE(R)
099			_a27648439
245			_aEndoscopic versus Percutaneous Biliary Drainage in Palliation of Advanced Malignant Hilar Obstruction: A Meta-Analysis and Systematic Review. [Review]
251			_aCanadian Journal of Gastroenterology & Hepatology. 2016:4726078, 2016
252			_aCan J Gastroenterol Hepatol. 2016:4726078, 2016
253			_aCanadian journal of gastroenterology & hepatology
260			_c2016
260			_fFY2016
266			_d2017-04-11
520			_aBackground. Palliation in advanced unresectable hilar malignancies can be achieved by endoscopic (EBD) or percutaneous transhepatic biliary drainage (PTBD). It is unclear if one approach is superior to the other in this group of patients. Aims. Compare clinical outcomes of EBD versus PTBD. Methods. (i) Study Selection Criterion. Studies using PTBD and EBD for palliation of advanced unresectable hilar malignancies. (ii) Data Collection and Extraction. Articles were searched in Medline, PubMed, and Ovid journals. (iii) Statistical Method. Fixed and random effects models were used to calculate the pooled proportions. Results. Initial search identified 786 reference articles, in which 62 articles were selected and reviewed. Data was extracted from nine studies (N = 546) that met the inclusion criterion. The pooled odds ratio for successful biliary drainage in PTBD versus EBD was 2.53 (95% CI = 1.57 to 4.08). Odds ratio for overall adverse effects in PTBD versus EBD groups was 0.81 (95% CI = 0.52 to 1.26). Odds ratio for 30-day mortality rate in PTBD group versus EBD group was 0.84 (95% CI = 0.37 to 1.91). Conclusions. In patients with advanced unresectable hilar malignancies, palliation with PTBD seems to be superior to EBD. PTBD is comparable to EBD in regard to overall adverse effects and 30-day mortality.
546			_aEnglish
650			_a*Cholestasis/su [Surgery]
650			_a*Drainage/mt [Methods]
650			_a*Endoscopy/mt [Methods]
650			_a*Palliative Care/mt [Methods]
650			_aAdult
650			_aBile Duct Neoplasms/co [Complications]
650			_aBile Duct Neoplasms/pa [Pathology]
650			_aCholestasis/et [Etiology]
650			_aFemale
650			_aHumans
650			_aKlatskin Tumor/co [Complications]
650			_aKlatskin Tumor/pa [Pathology]
650			_aMale
650			_aMiddle Aged
650			_aOdds Ratio
651			_aMedStar Washington Hospital Center _91002
656			_aMedicine/General Internal Medicine
657			_aJournal Article
657			_aReview
700			_aYerasi, Charan _91013
858			_yYerasi, Charan _uhttps://orcid.org/0000-0002-3916-3216 _zhttps://orcid.org/0000-0002-3916-3216
942			_cART _2z _dArticle
999			_c10943 _d10943