Metal vs plastic stents for preoperative biliary drainage in patients with periampullary cancer: An updated systematic review and meta‐analysis
Background/Purpose Metal stents (MS) are recommended for preoperative biliary drainage (PBD) in patients with periampullary cancer, but whether MS are superior in terms of re‐intervention and direct cost is debatable. This study aimed to compare the effects of MS and PS on the outcomes of patients w...
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| Vydáno v: | Journal of hepato-biliary-pancreatic sciences Ročník 30; číslo 1; s. 6 - 20 |
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| Hlavní autoři: | , , , , |
| Médium: | Journal Article |
| Jazyk: | angličtina |
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Japan
Wiley Subscription Services, Inc
01.01.2023
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| ISSN: | 1868-6974, 1868-6982, 1868-6982 |
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| Abstract | Background/Purpose
Metal stents (MS) are recommended for preoperative biliary drainage (PBD) in patients with periampullary cancer, but whether MS are superior in terms of re‐intervention and direct cost is debatable. This study aimed to compare the effects of MS and PS on the outcomes of patients with periampullary cancer.
Methods
For this random‐effects meta‐analysis, electronic databases were screened for randomized controlled trials (RCTs) published until January 2022. Subgroup analyses were performed basis on the center type and presence of NAC.
Results
In this meta‐analysis, seven RCTs (440 participants) were included. MS reduced re‐interventions (risk ratio [RR] = 0.42, 95% confidence interval [CI] = 0.25‐0.72) and direct costs (mean difference = −474 USD, 95% CI = −656 to −292). PBD‐related complications (RR = 0.74, 95% CI = 0.32‐1.71) and postoperative complications (RR = 0.73, 95% CI = 0.45‐1.17) did not differ between MS and PS. Compared PS, MS reduced postoperative complications in high‐volume centers (RR = 0.64, 95% CI = 0.49‐0.84) and PBD‐related complications in patients receiving NAC (RR = 0.29, 95% CI = 0.08‐1.08).
Conclusions
Metal stents likely reduces re‐interventions and direct costs. Further studies are needed to confirm the effects of MS on the outcomes. |
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| AbstractList | Metal stents (MS) are recommended for preoperative biliary drainage (PBD) in patients with periampullary cancer, but whether MS are superior in terms of re-intervention and direct cost is debatable. This study aimed to compare the effects of MS and PS on the outcomes of patients with periampullary cancer.
For this random-effects meta-analysis, electronic databases were screened for randomized controlled trials (RCTs) published until January 2022. Subgroup analyses were performed basis on the center type and presence of NAC.
In this meta-analysis, seven RCTs (440 participants) were included. MS reduced re-interventions (risk ratio [RR] = 0.42, 95% confidence interval [CI] = 0.25-0.72) and direct costs (mean difference = -474 USD, 95% CI = -656 to -292). PBD-related complications (RR = 0.74, 95% CI = 0.32-1.71) and postoperative complications (RR = 0.73, 95% CI = 0.45-1.17) did not differ between MS and PS. Compared PS, MS reduced postoperative complications in high-volume centers (RR = 0.64, 95% CI = 0.49-0.84) and PBD-related complications in patients receiving NAC (RR = 0.29, 95% CI = 0.08-1.08).
Metal stents likely reduces re-interventions and direct costs. Further studies are needed to confirm the effects of MS on the outcomes. Background/Purpose Metal stents (MS) are recommended for preoperative biliary drainage (PBD) in patients with periampullary cancer, but whether MS are superior in terms of re‐intervention and direct cost is debatable. This study aimed to compare the effects of MS and PS on the outcomes of patients with periampullary cancer. Methods For this random‐effects meta‐analysis, electronic databases were screened for randomized controlled trials (RCTs) published until January 2022. Subgroup analyses were performed basis on the center type and presence of NAC. Results In this meta‐analysis, seven RCTs (440 participants) were included. MS reduced re‐interventions (risk ratio [RR] = 0.42, 95% confidence interval [CI] = 0.25‐0.72) and direct costs (mean difference = −474 USD, 95% CI = −656 to −292). PBD‐related complications (RR = 0.74, 95% CI = 0.32‐1.71) and postoperative complications (RR = 0.73, 95% CI = 0.45‐1.17) did not differ between MS and PS. Compared PS, MS reduced postoperative complications in high‐volume centers (RR = 0.64, 95% CI = 0.49‐0.84) and PBD‐related complications in patients receiving NAC (RR = 0.29, 95% CI = 0.08‐1.08). Conclusions Metal stents likely reduces re‐interventions and direct costs. Further studies are needed to confirm the effects of MS on the outcomes. Background/PurposeMetal stents (MS) are recommended for preoperative biliary drainage (PBD) in patients with periampullary cancer, but whether MS are superior in terms of re‐intervention and direct cost is debatable. This study aimed to compare the effects of MS and PS on the outcomes of patients with periampullary cancer.MethodsFor this random‐effects meta‐analysis, electronic databases were screened for randomized controlled trials (RCTs) published until January 2022. Subgroup analyses were performed basis on the center type and presence of NAC.ResultsIn this meta‐analysis, seven RCTs (440 participants) were included. MS reduced re‐interventions (risk ratio [RR] = 0.42, 95% confidence interval [CI] = 0.25‐0.72) and direct costs (mean difference = −474 USD, 95% CI = −656 to −292). PBD‐related complications (RR = 0.74, 95% CI = 0.32‐1.71) and postoperative complications (RR = 0.73, 95% CI = 0.45‐1.17) did not differ between MS and PS. Compared PS, MS reduced postoperative complications in high‐volume centers (RR = 0.64, 95% CI = 0.49‐0.84) and PBD‐related complications in patients receiving NAC (RR = 0.29, 95% CI = 0.08‐1.08).ConclusionsMetal stents likely reduces re‐interventions and direct costs. Further studies are needed to confirm the effects of MS on the outcomes. Metal stents (MS) are recommended for preoperative biliary drainage (PBD) in patients with periampullary cancer, but whether MS are superior in terms of re-intervention and direct cost is debatable. This study aimed to compare the effects of MS and PS on the outcomes of patients with periampullary cancer.BACKGROUND/PURPOSEMetal stents (MS) are recommended for preoperative biliary drainage (PBD) in patients with periampullary cancer, but whether MS are superior in terms of re-intervention and direct cost is debatable. This study aimed to compare the effects of MS and PS on the outcomes of patients with periampullary cancer.For this random-effects meta-analysis, electronic databases were screened for randomized controlled trials (RCTs) published until January 2022. Subgroup analyses were performed basis on the center type and presence of NAC.METHODSFor this random-effects meta-analysis, electronic databases were screened for randomized controlled trials (RCTs) published until January 2022. Subgroup analyses were performed basis on the center type and presence of NAC.In this meta-analysis, seven RCTs (440 participants) were included. MS reduced re-interventions (risk ratio [RR] = 0.42, 95% confidence interval [CI] = 0.25-0.72) and direct costs (mean difference = -474 USD, 95% CI = -656 to -292). PBD-related complications (RR = 0.74, 95% CI = 0.32-1.71) and postoperative complications (RR = 0.73, 95% CI = 0.45-1.17) did not differ between MS and PS. Compared PS, MS reduced postoperative complications in high-volume centers (RR = 0.64, 95% CI = 0.49-0.84) and PBD-related complications in patients receiving NAC (RR = 0.29, 95% CI = 0.08-1.08).RESULTSIn this meta-analysis, seven RCTs (440 participants) were included. MS reduced re-interventions (risk ratio [RR] = 0.42, 95% confidence interval [CI] = 0.25-0.72) and direct costs (mean difference = -474 USD, 95% CI = -656 to -292). PBD-related complications (RR = 0.74, 95% CI = 0.32-1.71) and postoperative complications (RR = 0.73, 95% CI = 0.45-1.17) did not differ between MS and PS. Compared PS, MS reduced postoperative complications in high-volume centers (RR = 0.64, 95% CI = 0.49-0.84) and PBD-related complications in patients receiving NAC (RR = 0.29, 95% CI = 0.08-1.08).Metal stents likely reduces re-interventions and direct costs. Further studies are needed to confirm the effects of MS on the outcomes.CONCLUSIONSMetal stents likely reduces re-interventions and direct costs. Further studies are needed to confirm the effects of MS on the outcomes. |
| Author | Sasanuma, Hideki Sata, Naohiro Miki, Atsushi Watanabe, Jun Kotani, Kazuhiko |
| Author_xml | – sequence: 1 givenname: Jun orcidid: 0000-0003-4477-4238 surname: Watanabe fullname: Watanabe, Jun email: m06105jw@jichi.ac.jp organization: Jichi Medical University – sequence: 2 givenname: Atsushi surname: Miki fullname: Miki, Atsushi organization: Jichi Medical University – sequence: 3 givenname: Hideki surname: Sasanuma fullname: Sasanuma, Hideki organization: Jichi Medical University – sequence: 4 givenname: Kazuhiko surname: Kotani fullname: Kotani, Kazuhiko organization: Jichi Medical University – sequence: 5 givenname: Naohiro surname: Sata fullname: Sata, Naohiro organization: Jichi Medical University |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/35466557$$D View this record in MEDLINE/PubMed |
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Metal stents (MS) are recommended for preoperative biliary drainage (PBD) in patients with periampullary cancer, but whether MS are superior... Metal stents (MS) are recommended for preoperative biliary drainage (PBD) in patients with periampullary cancer, but whether MS are superior in terms of... Background/PurposeMetal stents (MS) are recommended for preoperative biliary drainage (PBD) in patients with periampullary cancer, but whether MS are superior... |
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| SubjectTerms | Cancer drainage Drainage - adverse effects Humans Meta-analysis Metals neoadjuvant therapy Neoplasms Pancreatic cancer pancreatic neoplasms Plastics Postoperative Complications - etiology Stents Stents - adverse effects systematic review |
| Title | Metal vs plastic stents for preoperative biliary drainage in patients with periampullary cancer: An updated systematic review and meta‐analysis |
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