Objective To evaluate the clinical efficacy of endoscopic nasobiliary drainage(ENBD)and percutaneous transhepatic cholangial drainage(PTCD)as two types of bile duct drainage methods in the treatment of acute cholangitis of severe type(ACST),so as to investigate their clinical application value.Methods Database for clinical research on the comparison of therapeutic efficacy between ENBD and PTCD on ACST were retrieved in PubMed,EMBASE,Medline,Web of Science,CNKI and Wanfang.The retrieval time was from January 1,2010 to August 31,2023.The observation indices include operation time,hospitalization time,response rate,mortality rate and total incidence of complications.After extracting the relevant data,meta-analysis was carried out with RevMan 5.4 software.Results A total of 5 retrospective cohort conforming research were included,with a literature cumulative sample size of 345 cases,and they were divided into the ENBD group(n=191)and the PTCD group(n=154).Meta-analysis results showed that there were no statistically significant differences in hospitalization time(WMD=-0.96,95％CI[-1.92,0.01],P=0.05)and mortality rate(OR=0.87,95％CI[0.43,1.73],P=0.68)between the two groups(P＞0.05).The response rate(OR=2.43,95％CI[1.09,5.44],P=0.03)in the ENBD group was higher than that in the PTCD group,and the total incidence of complications(OR=0.33,95％CI[0.14,0.74],P=0.007)in the PTCD group was higher than that in the ENBD group,with statistically significant differences(P＜0.05).Conclusion For patients with ACST,the clinical treatment efficacy of ENBD is superior to that of PTCD,which is a safe and effective way of bile duct drainage.
关键词
急性重症胆管炎/急性梗阻性化脓性胆管炎/内镜下鼻胆管引流术/经皮经肝胆管穿刺引流术/meta分析
Key words
Acute cholangitis of severe type/Acute obstructive suppurative cholangitis/Endoscopic nasobiliary drainage/Percutaneous transhepatic cholangial drainage/meta-analysis
维普
万方数据