Abstract
BACKGROUND: Malignant biliary obstruction (MBO) impacts patient health and quality of life. Biliary drainage techniques, including percutaneous transhepatic biliary drainage (PTBD) and endoscopic biliary drainage (EBD), are commonly used, yet their relative advantages remain unclear. OBJECTIVE: To compare the effectiveness and complications of EBD and PTBD in treating MBO. METHODS: A systematic literature search in databases such as PubMed and EMBASE identified case-control trials comparing EBD and PTBD from January 2010 to the present. Five studies comprising 721 participants were analyzed. Outcome measures included technical success rate, incidence of complications, post-drainage pancreatitis, bleeding, major complications, hospital stay duration, and implant metastasis rates. Statistical analysis was conducted using RevMan 5.3 software. RESULTS: There was no significant difference between the two groups regarding major complications, bleeding incidents, hospital stay, or implantation metastasis rates. However, PTBD showed a significantly lower incidence of complications and post-drainage pancreatitis compared to EBD. CONCLUSION: PTBD may offer advantages over EBD in managing MBO, including fewer complications and reduced incidence of pancreatitis, suggesting PTBD as a potentially safer and more effective treatment option. Nonetheless, further large-scale, high-quality studies are needed to validate these findings.