Radioactive versus normal stent insertion for malignant hilar obstruction: a meta-analysis

Area of Science:

• Gastroenterology and Hepatology
• Interventional Oncology
• Biliary Interventions

Background:

• Malignant hilar obstruction (MHO) poses significant challenges in patient management.
• Evaluating the comparative efficacy and safety of different stenting techniques is crucial for improving patient outcomes.

Approach:

• A meta-analysis was conducted, synthesizing data from eight studies.
• Searches were performed across Medline, Embase, Wanfang, and CNKI databases up to March 2022.
• Pooled results from 258 normal stent (NS) and 247 radioactive stent (RS) insertions were analyzed.

Key Points:

• Radioactive stent (RS) insertion demonstrated significant improvements in functional success rate, liver enzymes (AST, ALT), stent patency, and reduced re-obstruction rates compared to normal stent (NS) insertion.
• Overall survival (OS) was significantly prolonged with RS insertion.
• No significant differences were observed in total bilirubin levels, cholangitis, cholecystitis, or hemorrhage rates between RS and NS groups.

Conclusions:

• Radioactive stent (RS) insertion is a clinically effective option for managing malignant hilar obstruction (MHO).
• RS insertion offers superior stent patency and overall survival benefits over NS insertion.
• Further investigation may be needed to address publication bias observed for specific endpoints.