{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T01:08:06Z","timestamp":1777943286691,"version":"3.51.4"},"reference-count":20,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2020,3,14]],"date-time":"2020-03-14T00:00:00Z","timestamp":1584144000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Surg Innov"],"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:p>Aims. To compare short-term and long-term outcomes of preoperative endoscopic biliary drainage (EBD) and percutaneous biliary drainage (PBD) in patients with Klatskin tumor undergoing curative surgery. Methods. We conducted a search of electronic information sources to identify all studies comparing EBD and PBD in patients with Klatskin tumor undergoing curative surgery. We used the Newcastle-Ottawa Scale to assess the risk of bias observational studies. Random-effects or fixed-effects modeling was applied as appropriate to calculate pooled outcome data. Results. We identified 9 observational studies, enrolling a total of 1436 patients. The patients in the PBD group had more advanced disease than those in EBD group in terms of Bismuth-Corlette classification and tumor classification. EBD was associated with higher risks of postprocedural complications (odds ratio [OR] =2.24, P = .001), conversion to another drainage method (OR =11.16, P &lt; .00001), cholangitis (OR = 4.58, P &lt; .0001), and pancreatitis (OR = 8.90, P = .009) than PBD; there was no difference between the 2 methods in terms of technical success (OR = 0.79, P = .50) and tube dislocation (OR = 0.81, P = .54). Regarding the postoperative outcomes, there was no difference in terms of 30-day mortality (OR = 0.61, P = .16) and major postoperative complications (OR = 0.60, P = .06). Regarding the long-term outcomes, EBD was associated with lower risks of seeding metastasis (OR = 0.46, P = .0004) and 5-year recurrence (OR = 0.72, P = .010), and better 5-year survival (OR = 1.62, P = .001). Conclusions. EBD may be associated with higher procedure-related complications compared with PBD as a preoperative biliary drainage method in patients with Klatskin tumor undergoing curative surgery. The available evidence on long-term oncological and survival outcomes are subject to confounding by indication, and high-quality randomized controlled trials are required for definite conclusions.<\/jats:p>","DOI":"10.1177\/1553350620911291","type":"journal-article","created":{"date-parts":[[2020,3,14]],"date-time":"2020-03-14T08:10:38Z","timestamp":1584173438000},"page":"279-290","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["Endoscopic Versus Percutaneous Preoperative Biliary Drainage in Patients With Klatskin Tumor Undergoing Curative Surgery: A Systematic Review and Meta-Analysis of Short-Term and Long-Term Outcomes"],"prefix":"10.1177","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3294-4335","authenticated-orcid":false,"given":"Shahab","family":"Hajibandeh","sequence":"first","affiliation":[{"name":"Glan Clwyd Hospital, Rhyl, Denbighshire, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6159-1068","authenticated-orcid":false,"given":"Shahin","family":"Hajibandeh","sequence":"additional","affiliation":[{"name":"Sandwell and West Birmingham Hospitals NHS Trust, Manchester, Birmingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Satyadas","sequence":"additional","affiliation":[{"name":"Manchester Royal Infirmary Hospital, Manchester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2020,3,14]]},"reference":[{"key":"bibr1-1553350620911291","doi-asserted-by":"publisher","DOI":"10.1586\/egh.12.20"},{"key":"bibr2-1553350620911291","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2005.02.021"},{"key":"bibr3-1553350620911291","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0908721"},{"key":"bibr4-1553350620911291","doi-asserted-by":"publisher","DOI":"10.1007\/s00535-010-0298-1"},{"key":"bibr5-1553350620911291","doi-asserted-by":"publisher","DOI":"10.4253\/wjge.v6.i3.68"},{"key":"bibr6-1553350620911291","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b2700"},{"key":"bibr7-1553350620911291","unstructured":"Wells GA, Shea B, O\u2019Connell D, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. http:\/\/www.ohri.ca\/programs\/clinical_epidemiology\/oxford.asp. 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