{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T11:35:49Z","timestamp":1790249749985,"version":"4.1.0"},"reference-count":16,"publisher":"Wiley","issue":"7-8","license":[{"start":{"date-parts":[[2021,4,27]],"date-time":"2021-04-27T00:00:00Z","timestamp":1619481600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100012151","name":"Sanming Project of Medicine in Shenzhen","doi-asserted-by":"publisher","award":["SZSM202011010"],"award-info":[{"award-number":["SZSM202011010"]}],"id":[{"id":"10.13039\/501100012151","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012151","name":"Sanming Project of Medicine in Shenzhen","doi-asserted-by":"publisher","award":["SZSM201911008"],"award-info":[{"award-number":["SZSM201911008"]}],"id":[{"id":"10.13039\/501100012151","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Although routine preoperative biliary drainage (PBD) is generally not recommended for patients with malignant distal biliary obstruction (MDBO), it is still necessary in many cases. The objective of this study is to compare the effects of metal stents (MSs) and plastic stents (PSs) on PBD in patients with MDBO.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All the randomized controlled trials (RCTs) that compared MS with PS for PBD and published from the date of database establishment to September 2020 were identified by searching the PubMed, EMBASE and Cochrane databases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Five RCTs involving 445 patients were included. There were 201 cases in the MS group, with 244 in the PS group. Re\u2010interventions (relative risk (RR)\u00a0=\u00a00.40, 95% confidence interval (CI) 0.21\u20130.75, <jats:italic>P<\/jats:italic>\u00a0=\u20090.004), stent occlusions (RR\u00a0=\u00a00.36, 95% CI 0.18\u20130.75, <jats:italic>P<\/jats:italic>\u00a0=\u20090.006), postoperative complications (RR\u00a0=\u00a00.76, 95% CI 0.59\u20130.97, <jats:italic>P<\/jats:italic>\u00a0=\u20090.03) and preoperative cholangitis (RR\u00a0=\u00a00.19, 95% CI 0.05\u20130.78, <jats:italic>P<\/jats:italic>\u00a0=\u20090.02) were lower in the MS group than in the PS group. Preoperative pancreatitis (RR\u00a0=\u00a02.11, 95% CI 1.06\u20134.19, <jats:italic>P<\/jats:italic>\u00a0=\u20090.03) was higher in the MS group than in the PS group. No significant difference was observed in the overall preoperative complications, postoperative pancreatic fistulas, delayed gastric emptying, wound infections and postoperative bleeding between these two groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>MS and PS exerted a similar effect on PBD, but PS had a higher risk of preoperative stent obstruction and postoperative complications, requiring more frequent interventions preoperatively. However, larger sample and higher quality RCTs are necessary for further verification.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.16899","type":"journal-article","created":{"date-parts":[[2021,4,28]],"date-time":"2021-04-28T04:37:42Z","timestamp":1619584662000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Comparison of metal stents versus plastic stents for preoperative biliary drainage: a meta\u2010analysis of five randomized controlled trials"],"prefix":"10.1111","volume":"91","author":[{"given":"Wei","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Pancreatic and Gastric Surgery National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Surgery National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital &amp; Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College  Shenzhen China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0936-0817","authenticated-orcid":false,"given":"Xu","family":"Che","sequence":"additional","affiliation":[{"name":"Department of Pancreatic and Gastric Surgery National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"},{"name":"Department of Hepatobiliary and Pancreatic Surgery National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital &amp; Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College  Shenzhen China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,4,27]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2007.12.014"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1055\/a-0659-9864"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00534-011-0403-8"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12957-020-01848-1"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000100"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/jhbp.811"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2014.02.1018"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0043-110565"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2016.04.018"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2014-308762"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/den.12394"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-010-1552-6"},{"key":"e_1_2_10_14_1","first-page":"309","article-title":"Self\u2010expanding metal stents (SEMS) provide superior outcomes compared to plastic stents for pancreatic cancer patients undergoing neoadjuvant therapy","volume":"3","author":"Adams MA","year":"2012","journal-title":"J. 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