Radioactive stent versus normal stent insertion for inoperable malignant biliary obstruction: a systematic review and meta-analysis.

IF 2.7 2区医学 Q2 SURGERY Surgical Endoscopy And Other Interventional Techniques Pub Date : 2025-04-01 Epub Date: 2025-03-06 DOI:10.1007/s00464-025-11571-1

Xiang Chen, Jiaxing Li, Wenwu Wan, Hao Zhang, Ding Xiong

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Abstract

Purpose: This systematic review and meta-analysis examined the comparative efficacy and safety of radioactive stents versus normal metal stents for the management of malignant biliary obstruction (MBO).

Methods: A comprehensive search of databases including PubMed, the Cochrane Library, and Embase was conducted to identify pertinent studies up to June 2024. The primary focus of this meta-analysis is on stent patency, postoperative survival, and the incidence of complications.

Results: The meta-analysis revealed that there was no statistically significant difference in the occurrence of complications, such as bleeding (p = 0.32), cholangitis (P = 0.19), pancreatitis (P = 0.43), and cholecystitis (P = 0.99), between the two types of stents. However, the radioactive stent demonstrated a significant improvement in both stent patency time (HR = 0.60, 95% CI 0.50-0.73; P < 0.001) and patient survival time (HR = 0.63, 95% CI 0.53-0.74, P < 0.001).

Conclusion: The results indicate that radioactive stents could present a more effective option compared to traditional stents for palliative management of malignant biliary obstruction, resulting in prolonged stent patency and potentially enhancing survival rates.

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放射性支架与正常支架置入治疗无法手术的恶性胆道梗阻：一项系统回顾和荟萃分析。

目的：本系统综述和荟萃分析比较了放射性支架与正常金属支架治疗恶性胆道梗阻（MBO）的疗效和安全性。方法：对PubMed、Cochrane Library和Embase等数据库进行全面检索，确定截至2024年6月的相关研究。这项荟萃分析的主要焦点是支架通畅、术后生存和并发症的发生率。结果：meta分析显示，两种支架在出血（p = 0.32）、胆管炎（p = 0.19）、胰腺炎（p = 0.43）、胆囊炎（p = 0.99）等并发症的发生方面，差异均无统计学意义。然而，放射性支架在两种支架通畅时间上均有显著改善(HR = 0.60, 95% CI 0.50-0.73；结论：与传统支架相比，放射性支架对于恶性胆道梗阻的姑息性治疗是一种更有效的选择，可以延长支架的通畅期，并可能提高生存率。

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

Surgical Endoscopy And Other Interventional Techniques 医学-外科

CiteScore

6.10

自引率

12.90%

发文量

890

审稿时长

6 months

期刊介绍： Uniquely positioned at the interface between various medical and surgical disciplines, Surgical Endoscopy serves as a focal point for the international surgical community to exchange information on practice, theory, and research. Topics covered in the journal include: -Surgical aspects of: Interventional endoscopy, Ultrasound, Other techniques in the fields of gastroenterology, obstetrics, gynecology, and urology, -Gastroenterologic surgery -Thoracic surgery -Traumatic surgery -Orthopedic surgery -Pediatric surgery