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

Purpose: This meta-analysis was designed for examining the relative clinical safety and efficacy of normal stent (NS) and radioactive stent (RS) insertion in malignant hilar obstruction (MHO) patients.

Material And Methods: Relevant studies published as of March 2022 were identified through searches of the Medline, Embase, Wanfang, and CNKI databases, and the pooled results of these studies were then analyzed.

Results: Eight studies including 258 and 247 patients that underwent NS and RS insertion, respectively, were incorporated into this meta-analysis. RS insertion was found to be associated with significant improvements in functional successful rate ( = 0.04), Δaspertate aminotransferase (AST,  = 0.0004), Δalanine aminotransferase (ALT,  = 0.002), stent patency ( < 0.00001), stent re-obstruction rate ( = 0.03), and OS ( < 0.00001) outcomes as compared to those associated with NS insertion. No differences in Δtotal bilirubin (TBIL,  = 0.38), cholangeitis rate ( = 0.45), cholecystitis rate ( = 0.84), or hemorrhage rate ( = 0.87) were observed when comparing patients that underwent RS and NS insertion. Substantial publication bias was observed for endpoints of cholecystitis and hemorrhage.

Conclusions: These results suggest that relative to NS insertion, RS insertion can effectively prolong stent patency and OS in MHO cases.