Safety and efficacy of side-by-side versus stent-in-stent stenting for malignant hilar biliary obstruction: a systematic review and meta-analysis.

IF 4.3 3区材料科学 Q1 ENGINEERING, ELECTRICAL & ELECTRONIC

ACS Applied Electronic Materials Pub Date : 2024-08-27 eCollection Date: 2024-01-01 DOI:10.1177/17562848241271962

Haibin Zhou, Hayat Khizar, Ashraf Ali, Jianfeng Yang

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引用次数: 0

Abstract

Objectives: Stenting of the malignant hilar biliary obstruction (MHBO) area for bile drainage is challenging. Bilateral stenting techniques of stent-in-stent (SIS) and stent-by-stent (SBS) have shown promising results. This study evaluates the efficacy of different stenting methods for MHBO.

Design: A meta-analysis was performed to determine the efficacy of SIS and SBS stenting strategies for MHBO.

Data sources and methods: Medical databases such as PubMed, Web of Science, Embase, and Scopus, were searched up to August 2023. We selected eligible studies reporting the data on technical and clinical success, adverse events, and incidence of re-obstruction (RO) of SBS and SIS groups in MHBO patients. We compared the outcomes of SBS and SIS groups.

Results: A total of 9 studies comparing the data of 545 patients (268 in the SBS group and 277 in the SIS stenting group) were analyzed. There was no significant difference (p > 0.05) in the odds ratio (OR) of Re-obstruction (RO) 0.87 (95% confidence interval (95% CI) 0.6-1.25), technical success 0.58 (95% CI 0.16-2.11), clinical success 1.13 (95% CI 0.62-2.07), and adverse events 1.53 (95% CI 0.88-2.64). The mean difference in procedure time was -12.25 min (95% CI -18.39, -6.12), and the hazard ratio of stent patency was 1.22 (95% CI 1.01-1.47), favoring SBS, with high heterogeneity (I ² = 94%). There was no significant difference in HR for survival 1.05 (95% CI 0.95-1.16) with high heterogeneity (I ² = 84%).

Conclusion: Compared with SIS, SBS showed better stent patency with comparable technical and clinical success and adverse events.

Prospero registration: The registration number for this study on PROSPERO is CRD42024523230.

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并排支架与支架内支架治疗恶性胆道梗阻的安全性和有效性：系统回顾和荟萃分析。

目的：在恶性肝胆管梗阻（MHBO）区域安装支架进行胆汁引流具有挑战性。支架内支架（SIS）和逐个支架（SBS）的双侧支架技术已显示出良好的效果。本研究评估了不同支架植入方法对 MHBO 的疗效：数据来源和方法：检索了截至2023年8月的医学数据库，如PubMed、Web of Science、Embase和Scopus。我们选择了符合条件的研究，这些研究报告了MHBO患者中SBS组和SIS组的技术和临床成功率、不良事件和再梗阻（RO）发生率。我们比较了 SBS 组和 SIS 组的结果：结果：共分析了 9 项研究中 545 例患者（SBS 组 268 例，SIS 支架组 277 例）的数据。在再梗阻（RO）的几率比（OR）0.87（95% 置信区间（95% CI）0.6-1.25）、技术成功率 0.58（95% CI 0.16-2.11）、临床成功率 1.13（95% CI 0.62-2.07）和不良事件 1.53（95% CI 0.88-2.64）方面无明显差异（P > 0.05）。手术时间的平均差异为-12.25分钟（95% CI -18.39，-6.12），支架通畅的危险比为1.22（95% CI 1.01-1.47），SBS更优，异质性较高（I 2 = 94%）。存活率1.05（95% CI 0.95-1.16）无明显差异，异质性较高（I 2 = 84%）：结论：与 SIS 相比，SBS 的支架通畅率更高，技术和临床成功率以及不良事件发生率相当：本研究在 PROSPERO 上的注册号为 CRD42024523230。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

ACS Applied Electronic Materials Multiple-

CiteScore

7.20

自引率

4.30%

发文量

567