Evidence map›Paper›PMID 27154803›Full record

SynthesisHPB : the official journal of the International Hepato Pancreato Biliary Association2016

Percutaneous vs. endoscopic pre-operative biliary drainage in hilar cholangiocarcinoma - a systematic review and meta-analysis.

Ahmer Hameed, Tony Pang, Judy Chiou, Henry Pleass, Vincent Lam, Michael Hollands, Emma Johnston, Arthur Richardson, Lawrence Yuen

2 registry-linked trialsOpen access · bronzeAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in HPB : the official journal of the International Hepato Pancreato Biliary Association, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 35 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
35citing papers in PubMed, 1 pooled it
11.0field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07325877 nanot yet recruitingnot on this mapstarted 2026, after this paper: background citation

Supra-papillary Versus Trans-papillary Biliary Stenting in Malignant Peri-hilar Stenosis (SupraBilS): a Randomized Controlled Trial

TypeinterventionalSponsorAzienda Ospedaliera Universitaria Integrata VeronaRan2026 to 2029Enrolled70ConditionsBiliary Disease Tract, Biliary Stenosis, Biliary StentsArmsERCP with suprapapillary stent placement, ERCP with transpapillary stent placement
NCT07558304 nanot yet recruitingnot on this mapstarted 2026, after this paper: background citation

Randomized Clinical Trial of Suprapapillary Drainage With Metal Stent vs. Routine Internal-External Transpapillary Drainage in Patients With Malignant Hilar Biliary Obstruction

TypeinterventionalSponsorHospital de Clinicas de Porto AlegreRan2026 to 2028Enrolled84ConditionsCholangiocarcinoma, Bile Duct Neoplasms, Malignant Biliary ObstructionArmsPercutaneous transpapillary internal-external biliary drainage, Percutaneous suprapapillary biliary drainage with self-expanding metal stent
3 · Its place in the literature

Who cites it

35 citing papers in PubMed, 1 synthesis or guideline pooled it, 106 citations in OpenAlex.

  1. Pooled it
  2. An Unsuccessful Randomized Trial of Percutaneous vs Endoscopic Drainage of Suspected Malignant Hilar Obstruction.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2021
    Trial
  3. Article
  4. Role of Endoscopy in Malignant Biliary Obstruction.Diagnostics (Basel, Switzerland) · 2026
    Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 1 institution in 1 country.

Ahmer HameedDepartment of Surgery, Westmead Hospital, Sydney, Australia; Discipline of Surgery, University of Sydney, Australia.
Tony PangDepartment of Surgery, Westmead Hospital, Sydney, Australia; Discipline of Surgery, University of Sydney, Australia.
Judy ChiouDepartment of Medicine, Westmead Hospital, Sydney, Australia.
Henry PleassDepartment of Surgery, Westmead Hospital, Sydney, Australia; Discipline of Surgery, University of Sydney, Australia.
Vincent LamDepartment of Surgery, Westmead Hospital, Sydney, Australia; Discipline of Surgery, University of Sydney, Australia.
Michael HollandsDepartment of Surgery, Westmead Hospital, Sydney, Australia; Discipline of Surgery, University of Sydney, Australia.
Emma JohnstonDepartment of Surgery, Westmead Hospital, Sydney, Australia.
Arthur RichardsonDepartment of Surgery, Westmead Hospital, Sydney, Australia; Discipline of Surgery, University of Sydney, Australia.
Lawrence YuenDepartment of Surgery, Westmead Hospital, Sydney, Australia; Discipline of Surgery, University of Sydney, Australia. Electronic address: lawrence.yuen@sydney.edu.au.
Westmead Hospital · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe strategy for preoperative management of biliary obstruction in hilar cholangiocarcinoma (HCCA) patients with regards to drainage by endoscopic (EBD) or percutaneous (PTBD) methods is not clearly defined. The aim of this study was to investigate the utility, complications and therapeutic efficacy of these methods in HCCA patients, with a secondary aim to assess the use of portal vein embolization (PVE) in patients undergoing drainage.

methodsStudies incorporating HCCA patients undergoing biliary drainage prior to curative resection were included (EMBASE and Medline databases). Analyses included baseline drainage data, procedure-related complications and efficacy, post-operative parameters, and meta-analyses where applicable.

resultsFifteen studies were included, with EBD performed in 536 patients (52%). Unilateral drainage of the future liver remnant was undertaken in 94% of patients. There was a trend towards higher procedure conversion (RR 7.36, p = 0.07) and cholangitis (RR 3.36, p = 0.15) rates in the EBD group. Where specified, 134 (30%) drained patients had PVE, in association with a major hepatectomy in 131 patients (98%). Post-operative hepatic failure occurred in 22 (11%) of EBD patients compared to 56 (13%) of PTBD patients, whilst median 1-year survival in these groups was 91% and 73%, respectively. DISCUSSION: The accepted practice is for most jaundiced HCCA patients to have preoperative drainage of the future liver remnant. EBD may be associated with more immediate procedure-related complications, although it is certainly not inferior compared to PTBD in the long term.

Indexed as

EndoscopyBile Duct NeoplasmsCholestasisDrainageEmbolization, TherapeuticHepatectomyHumansJaundice, ObstructiveKlatskin TumorOdds RatioPortal VeinRisk FactorsSurvival AnalysisTime FactorsTreatment Outcome

Identifiers

PMID27154803
PMCPMC4857062
OpenAlexW2317398812

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.