Objective：To evaluate the effectiveness of preoperative biliary drainage (PBD) in patients with obstructive jaundice resulting from malignant tumors.
Methods：According to the requirements of Cochrane systematic review, a thorough literature search was performed in Medline and Embase electronic databases between 1995 and 2009 in terms of the key words preoperative biliary drainage, restricted articles for the English language. Two reviewers independently screened the studies for eligibility, evaluated the quality and extracted the data from the eligible studies with confirmation by cross-checking. Data were processed for a meta-analysis by Stata 9.2 software. Comparison was performed between PBD patients and patients without PBD, who both subsequently underwent resection of the malignant tumors, including the indices such as postoperative mortality, the incidence of postoperative pancreatic leakage, bile leakage, abdominal abscess, delayed gastric emptying and incision infection.
Results：There were 14 papers with 1 826 malignant obstructive jaundice patients selected and analysed, The combined RR values of postoperative mortality, the incidence of pancreatic leakage, bile leakage, abdominal abscess, and delayed gastric emptying between PBD patients and patients without PBD were not statistically significant (P=0.986, 0.364, 0.786, 0.819, 0.265, respectively); but the incidence of postoperative incision infection was improved in PBD group versus that in non-PBD group (P=0.002）.
Conclusions：PBD did not significantly improve the postoperative efficacy and safety in patients with malignant obstructive jaundice. Therefore, PBD may not be regarded as a preoperative routine measure for patients with malignant obstructive jaundice.