{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T20:03:39Z","timestamp":1791835419894,"version":"4.3.4"},"reference-count":46,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2023,1,20]],"date-time":"2023-01-20T00:00:00Z","timestamp":1674172800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Complications following the insertion T-tube or stent after common bile duct exploration (CBDE) remain problematic in nowadays surgical era. Based on our knowledge, we did not find any meta-analysis intentionally evaluating the complications between both groups. At this moment, we aimed to analyze and compare both procedures\u2019 complications, efficacy, efficiency, and feasibility.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We searched literature from four databases (EuroPMC, PubMed, Scopus, and ClinicalTrials.gov) up to June 2022 to compile the randomized controlled trials and pro-\/retrospective cohort studies. Review Manager 5.4 was used to statistically analyze each outcome measured between biliary stenting and T-tube insertion.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Sixteen studies with 1,080 patients (534 biliary stents and 546 T-tube) were included for qualitative and quantitative analysis. The pooled risk ratio (RR) of the overall postoperative complications rate was significantly lower in the biliary stent group compared to the T-tube group 0.43 [95% confidence interval (CI) 0.23\u20130.80, <jats:italic>p<\/jats:italic> = 0.007]. In terms of the operation time, length of hospital stay, and readmission rate was also decreased in stenting as biliary drainage over T-tube placement 1.02 minutes [95% CI -1.53, -0.52, <jats:italic>p<\/jats:italic> &lt; 0.0001], 1.96 days [95% CI -2.63, -1.29, <jats:italic>p<\/jats:italic> &lt; 0.00001], and RR 0.39 [95% CI 0.15\u20130.97, <jats:italic>p<\/jats:italic> = 0.04], respectively.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Stenting as biliary drainage after CBDE was superior to T-tube insertion. A shorter operation time and hospital stay in biliary drainage resulted in a lower overall postoperative complication rate. Other influences, including the complexity and shorter learning curve, might also affect the superiority of biliary stenting.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0280755","type":"journal-article","created":{"date-parts":[[2023,1,20]],"date-time":"2023-01-20T19:01:02Z","timestamp":1674241262000},"page":"e0280755","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":7,"title":["Complications of biliary stenting versus T-tube insertion after common bile duct exploration: A systematic review and meta-analysis"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6826-6313","authenticated-orcid":true,"given":"Reno","family":"Rudiman","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricarhdo Valentino","family":"Hanafi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"family":"Almawijaya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Freda","family":"Halim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,1,20]]},"reference":[{"key":"pone.0280755.ref001","first-page":"CD005641","article-title":"T-tube drainage versus primary closure after laparoscopic common bile duct exploration.","volume":"6","author":"KS Gurusamy","year":"2013","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"pone.0280755.ref002","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1055\/s-0036-1592329","article-title":"Choledocholithiasis: Evaluation, Treatment, and Outcomes.","volume":"33","author":"C Molvar","year":"2016","journal-title":"Semin Intervent Radiol"},{"key":"pone.0280755.ref003","doi-asserted-by":"crossref","first-page":"1485","DOI":"10.1007\/s00268-008-9475-2","article-title":"Is a T-tube Necessary after Common Bile Duct Exploration?","volume":"32","author":"I Ahmed","year":"2008","journal-title":"World J Surg"},{"key":"pone.0280755.ref004","doi-asserted-by":"crossref","first-page":"2530","DOI":"10.1007\/s00464-015-4518-x","article-title":"Laparoscopic common bile duct exploration using V-Loc suture with insertion of endobiliary stent.","volume":"30","author":"JS Lee","year":"2016","journal-title":"Surg Endosc"},{"key":"pone.0280755.ref005","doi-asserted-by":"crossref","first-page":"1506","DOI":"10.1001\/jama.2018.11812","article-title":"Choledocholithiasis.","volume":"320","author":"I Baiu","year":"2018","journal-title":"JAMA"},{"key":"pone.0280755.ref006","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1111\/den.13220","article-title":"Endoscopic papillary large balloon dilation and endoscopic papillary balloon dilation both without sphincterotomy for removal of large bile duct stones: A propensity\u2010matched analysis.","volume":"31","author":"R Hakuta","year":"2019","journal-title":"Digestive Endoscopy"},{"key":"pone.0280755.ref007","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1097\/00000658-192501010-00024","article-title":"The surgery of jaundice","volume":"81","author":"J. 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