To determine the impact and the risk factors of different methods of preope-rative biliary drainage (PBD) for malignant obstruction jaundice (MOJ) on overall survival (OS).

Databases including the PubMed, Medline, Web of Knowledge, and other databases were searched up to 30th April, 2018 for clinical studies which compared the OS rates between percutaneous transhepatic biliary drainage (PTBD) and endoscopic biliary drainage (EBD) for MOJ. Hazard ratio (HR) and Odds Ratio (OR) with 95% confidence interval (CI) were performed using the Review Manager 5.3 software to synthesize the results.

Nine studies were enrolled in this meta-analysis, which included 818 patients in the PTBD group and 1253 patients in the EBD group. EBD was shown to be superior to PTBD in OS (HR=0.63, 95% CI: 0.51~0.77, P<0.05). Risk factors analysis showed that patients in the EBD group had a higher rate of early tumor stage (P<0.05) and a lower rate of lymphatic metastasis (P<0.05). When compared with the PTBD group, the EBD group had a lower rate of intraoperative bleeding (P<0.05), and a higher rate of adjuvant therapy (P<0.05).

In PBD for patients with resectable MOJ, there was insufficient evidence to support EBD to be superior to PTBD in OS.

Malignant obstruction jaundice; Preoperative biliary drainage; Percutaneous transhepatic biliary drainage; Endoscopic biliary drainage; Overall survival; Meta-analysis