Comparison Of Clinical Efficacy And Safety Of Between ERCP And PTCD In Treatment Of Malignant Obstructive Jaundice: A Meta-analysis

Objective:To systematically evaluate the clinical efficacy and safety of PTCD and ERCP in the treatment of malignant obstructive jaundice.Methods:Literatures about the use of PTCD or ERCP for MOJ were collected among CNKI,VIP,CBM,Wanfang,Cochrane and Pub Med by computer.Rev Man 5.4.1 was used for data analysis.The rate of success,jaundice remission rate,clinical efficacy,changes of liver function indexes(ALT,AST,TBIL,DBIL)after surgery,and the incidence of complication were compared between the two groups.Results:About 15 literatures were included in this study,including 1235 cases.The PTCD group had a higher overall surgical success rate(P=0.02).Patients with low obstruction had higher jaundice remission rate(P=0.006)and better clinical efficacy(P=0.0005)after ERCP,while patients with high obstruction had higher jaundice remission rate(P<0.0001)and better clinical efficacy(P<0.0001)after PTCD.There was no significant difference in the overall jaundice remission rate and clinical efficacy between the two groups(P=0.09,P=0.13).The changes of ALT,AST,TBIL and DBIL after surgery and the incidence of complication between the two groups showed no statistical difference.Conclusion:The two measures can both effectively relieve biliary obstruction and improve liver function.Patients with low obstruction can get better efficacy after ERCP.Patients with high obstruction can get better efficacy after PTCD.